COLUMBIA LIBRARIES OFFSITE
HEALTH SCIENCES STANDARD
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HE DOCTOR'S
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1AMES ROBB CHURCH
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THE DOCTOR'S PART
First Aid Post in a Ciiuik'ii
p. 243
THE
DOCTOR'S PART
WHAT HAPPENS TO THE WOUNDED IN WAR
BY
JAMES ROBB CHURCH, A.M., M,D.
COLONEL MEDICAL CORPS, V. S. ABMT
WITH FOREWORD BY
MAJOR-GENERAL WILLIAM C. GORGAS
8UBOEOX-GENERAL, U. S. ABMY
ILLUSTRATED
D. APPLETON AND COMPANY
NEW YORK LONDON
1918
Copyright, 1918, by
D. APPLETON AND COMPANY
1^5^5 1
CM
Printed in the United States of America
FOREWORD
These impressions of a Military Observer are
the results of over two years spent by Colonel
Church on the Western front as an Observer with
our Allies and later on the Staff of the Command-
ing General of the American Expeditionary Force.
His service of twenty years in our army, includ-
ing duty on the Mexican border and with the
First United States Volunteer Cavalry (Rough
Riders), in the war with Spain where he won the
-Medal of Honor for gallantry under fire, well
qualifies him for this important duty.
The author has presented in non-technical lan-
guage much information which will be of value to
Medical and line officers as they go abroad on
active duty with troops in France.
The book will also be read with interest by the
laity as Colonel Church has the happy faculty of
presenting the human side of his experiences in
an interesting manner.
He has given us a glimpse of certain side lights
of the great war not heretofore available.
July 1, 1918.
Washington, D. C.
W. C. GORQAS,
Surgeon General,
U. S. Army.
PREFACE
So much has already been written in regard to
the present war that any one who essays to add to
the sum total cannot help but wonder if there is
anything left unexpressed by those who have gone
before him.
The inclination to describe the many complex
phases which enter into modern conflict is per-
haps natural. There are two passions which are,
have always been, of paramount interest to man-
kind. Kipling voices this when he says, "Two
things greater than all things are, the first is love,
the second is war." And so I fancy that each
individual who has been given the opportunity to
view with his own material eyes a part of the
titanic struggle which at present convulses this
troubled world, believes that some of the events
which he has taken a part in may be of interest
to others.
And yet I am sure there must always be hidden
somewhere in the back of his mind the doubting
conviction that the events which seem so real to
him may lack, when expressed, the value which
they have in his own eyes.
George Moore, in his altogether charming and
entirely irresponsible writings, "Memoirs of My
Dead Life," says,
"Think of the writer of stories! Two, three,
or four more stories are required to make up the
9
PREFACE
requisite number of pages. The dusk has inter-
rupted his labor, and he rises from his writing-
table asking who will care whether the last stories
are written or left unwritten? If he writes them
his ideas will flicker green for a brief springtime,
they will enjoy a little summer; when his garden
is fading in the autumn his leaves will be well-
nigh forgotten; winter will overtake them sooner
than it overtakes his garden, perhaps. The flow-
ers he deemed immortal are more mortal than the
rose. 'Why/ he asks, 'should any one be inter-
ested in my stories any more than in the thousand
and one stories published this year? Mine are
among the number of trivial things that compose
the tedium which we call life.' "
In much the same way I am a little doubtful
as to whether the things I saw, and had a part in,
may have the same active interest to others that
they did for me.
During a busy period of more than two years
in embattled France I had ample opportunity to
observe the work which my French professional
brothers were doing, and the conditions under
which they worked from the first line trenches
where the wounds are made, back to the hospitals
of the inner area where the human wreckage is
patched and cobbled and coaxed again to full effi-
ciency, or to something which has a semblance to
man as God made him in His image.
The wastage in Medical personnel has been high
in the present war and the Sanitary Service has
paid its own red toll shoulder to shoulder with
the brothers of the Line. I believe this common
sacrifice in the cause has brought the two services
closer together than ever before: has enabled each
10
PREFACE
to become better acquainted with the fine qualities
of the other and to be more tolerant with the short-
comings.
I saw things which I cannot write of for^ ob-
vious Military reasons. I saw others which are
best left untold as the gratuitous transcription of
suffering and horror which should have no other
than a morbid interest to the layman.
The following pages comprise the impressions
of a Medical Military Observer of matters in his
own province, together with notes of other current
affairs. It is in no sense technical and it makes
no pretense to the dignity of "literature."
I hope that there may be something of interest
in it for those who look with wistful eyes to the
troubled East and wait with aching hearts for the
return of some one, "over there."
James Robb Church.
Washington, D. C,
July, 19I8.
11
CONTENTS
CHAPTER
I. Introductory
II. General Sanitary Service op the
French
III. Hospitals of the Interior
IV. The Zone of the Armies
V. Transportation
VI. Front Lines .
VII. Conclusion
PAGB
17
34
69
104
168
222
261
13
LIST OF ILLUSTRATIONS
First Aid Post in a Church . Frontispiece
PAOB
Red Cross Nurses at a Railway Station
Canteen Giving Coffee to the Wounded 61
Tent Wards, Showing One of the Type of
Tent Used by the French ... 61
Mutilated Soldier Learning to Engrave
with an Artificial Hand ... 79
Soldier with Double Amputation of the
Arms, Showing How Much May Be Ac-
complished with the Artificial Hands . 79
Fracture Ward in Blake's Hospital, Com-
monly Known There as the Machine
Shop 85
A Fracture Ward 85
Operating Room on a "Sanitary Train'* 145
Interior of a French Dental Ambulance.
This is a Rolling Dental Office, Com-
pletely Fitted and Mounted on an Auto-
mobile Truck 145
Transport of Wounded by Litter Through
a Trench 169
Wheel Litter Transport . . . . 169
15
LIST OF ILLUSTRATIONS
PAGS
Ambulance Drawn by Dogs . . . 185
Sanitary Dog . . . ''Red Cross Dog*'. . .
Dressing His Wounds .... 185
First Aid Post in Cellar Belonging to
Arab, ''Spahi'^ Troop .... 205
A Trench, Showing Sign Indicating Loca-
tion of a First Aid Station . . .205
16
THE DOCTOR'S PART
CHAPTER I
INTRODUCTORY
I SUPPOSE that prior to the present war few
of the people who make up our ten million and
odd of population had any more than a hazy
idea of what the army, which they paid taxes
to support, did to justify the expenditure.
Ideas were hazy because, in our remoteness, it
seemed that we were geographically immune
from attack, and consequently the armed
forces carried about the same interest as
father's old revolver, loaded and tucked away
in the back of the top bureau drawer: a tacit
concession to the possibility of the unexpected
burglar, but from any other standpoint of lit-
tle interest.
And so, when in 1915 I told some of my
17
THE DOCTOR'S PART
civilian friends that I had been ordered abroad
for duty as Mihtary Observer, they looked
slightly puzzled and after asking, "What do
you mean. Military Observer?" reverted to cur-
rent topics in a language they could under-
stand.
A Military Observer is an authorized inter-
national Village Pest: he is tolerated by bel-
ligerent powers because they may some time
desire themselves to be onlookers in a quarrel
which does not concern them. He is treated
with very perfect courtesy, but what he sees
is not nearly so much a matter of consequence
to the nation at war as to put something over
on the enemy. He is governed and hedged
about by very precise diplomatic conditions,
and transgression of them is more than apt to
result in his recall.
From his own standpoint, he is, to begin
with, a neutral: at least, he is very particular
to convey that impression to those with whom
he comes in contact. In the privacy of his
own mind it is allowable to give rein to his indi-
18
INTRODUCTORY
vidual wishes and sympathies, but aside from
that he must be a perfectly impersonal and
very inquisitive person.
His duties are to collect and transmit in-
formation : that is about the sum and substance
of the instructions he gets, and the methods
are a matter of his own personal resource and
ingenuity. The fact that he is an accredited
representative of his Government gives him a
certain standing with the country to which he
is sent, but aside from that it is a more or less
perfunctory status. In the first place, the
warring power is entirely too busy, as I have
said, to give up time which may be profitably
employed in that engaging pastime of "killing
your neighbor" to showing a benevolent neu-
tral exactly all the detail of the modus oper-
andi. In addition, there is also the justifiable
uncertainty as to which side the neutral might
take if he decided to break into a busy private
quarrel. The usual International procedure is
to carefully guard the safety and welfare of
the observers so that they may be returned in
19
THE DOCTOR'S PART
undamaged condition eventually to the country
which sent them. At stated intervals trips are
arranged for all the Observers in the country
and they are taken under the chaperonage of
a designated officer to such points as the fight-
ing host deems proper, and he shows as much as
is considered advisable. You do not see more
than that, either : as Ruggles of Red Gap said,
"it simply isn't done." The country you rep-
resent cannot make too many requests, for it
would be embarrassing to refuse them and
embarrassing to be refused. And there you
are! Which may go to show that the job of
collecting and forwarding useful information
from a country at war, to your own Govern-
ment is by no means a sinecure, but a job
which requires patience, tact and resource. If
you add to this the fact that all the interesting
things that you want to know about are cam-
ouflaged under a language which you thought
you knew something about until you heard the
rapid and careless way its inventors use it, it
may readily be understood that the life of the
W
2341527.
WAR DEPARTMENT
THE ADJUTANT GENERAL'S OFFICE
WASHINGTON
November 15, 1915.
From: The Adjutant General of the Army.
To; Major James R. Church, Medical Corps, Fort Crockett,
Texas, through the Commanding General, Eastern Depart-
ment.
Subject: Detail as Military Observer.
1. The Secretary of War details you as a military observer
with the French armies in the field.
2. The Secretary directs, as necessary in the military ser-
vice, that you repair to this city at the earliest practicable
date and report in person to the Chief of Staff for temporary
duty in his office for a period of fifteen days; that at the ex-
piration of this period you proceed to Paris, France, and
report to the American Ambassador at that capital for the
purpose of carrying out the instructions of the War Depart-
ment, and that upon the completion of the duty enjoined
you return to your proper station.
3. The Secretary of War appoints you an acting quarter-
master while on this duty. p ^ March
Adjutant General.
Rec'd Hq. Eastern Dept. Nov. 16, 1915
201 Church, James R. 1st Ind. was-mr
HQ. EASTERN DEPT., Nov. 17, 1915.— Through Depart-
ment Surgeon and Comdg. Officer, Ft. Crockett, Tex., to
Major James R. Church, Med. Corps. WAS
H.P.B. 2nd Ind.
Office Dept. Surgeon, E. D., Nov. 18, 1915— Through the
C. O. Ft. Crockett, to Major James R. Church, M.C.
RECD HCDG
AM 11/22/15
Thru Surgeon, to Maj. James R. Church, M C, 11/22/15
Author's Appointment as Military Observkh
IN France
^1
THE DOCTOR'S PART
Military Observer is not an idle one nor alto-
gether a bed of roses.
I knew all this as a matter of theory before
I went to France but, once there, I quickly
recognized the difference between theory and
practice.
In November, 1915, I received an order
which came in the nature of a surprise. (See
page 21.) The opportunity offered was a fas-
cinating one, but the novel demand which it
makes on one's resources would, I think, leave
the average man with some apprehension as to
whether he could measure up to the standard
expected of him.
I left the United States on the 15th of Jan-
uary, 1916, and after the usual winter cross-
ing, which was at that time little disturbed by
any apprehension of submarine menace, landed
at Liverpool; from Liverpool to London and,
after a short stay there, to France. The Chan-
nel crossing, even at that time, was a tedious
and delayed procedure, and one knew only a
short time in advance as to what port he would
22
INTRODUCTORY
sail from and at what he would arrive. We
crossed from Folkestone to Dieppe on the after-
ward ill-fated Sussex^ and if she had been
torpedoed that day, I think there might have
been an extended casualty list, for every avail-
able inch of space seemed to be occupied by
human freight. The cabins were full, the din-
ing saloon was jammed, all deck chairs occu-
pied, and many stood on deck during the five
or six bleak hours that it required to transport
us from Albion to Gaul. Fortunately, the sea
was smooth and there was none of the horror
of seasickness.
At Dieppe, in the darkness of a winter night,
we proved to the Alien Officer that we were suit-
able for entry into France, and I was chlded
for not showing the diplomatic passport which
I had and thus taking precedence over my tired
fellow passengers.
I unwittingly slipped one over on the Cus-
toms, for in my suit case I had about 500
American cigarettes on which I supposed I
should either have to pay duty or claim diplo-
ma
THE DOCTOR'S PART
matic exemption. However, the officer with
whom I was traveling put his hand baggage
down next to mine and the French examiner
opened two of his pieces, none of mine, assum-
ing that they all belonged to my fellow traveler,
and I went gayly and guiltily away.
We arrived at Paris at one in the morning
of the 29th of January, and at nine that night
received our first intimation, from the measure
of personal realization, that we were in a war-
ridden country.
Some three or four of us went that evening
to the Gaumont Palace Theater, over in the
Montmartre neighborhood, to a moving picture
performance. As we came out at the end of
the show we noticed that the city was darker
than usual and that there were crowds of peo-
ple in the streets, watching the skies. Pencils
of white light streaked the heavens and there
seemed to be a rapt attention in the air of all
the low-voiced French speaking people whom
we passed.
We went down through the gloomy streets
S4
INTRODUCTORY
of the Montmartre district, stumbling from one
curb to the other, and wondering when we
might hear the crash of falling bombs and the
reply of the French anti-aircraft guns. We
made an uneventful trip over to the Place de la
Concorde and came out there into the still dark-
ness of a winter night, which was interrupted
only by the flashing rays of the many search-
lights, which constantly shifted from one part
of the heavens to the other. After standing
there for what seemed to me an indefinite length
of time, we heard the Paris fire engines going
through the streets sounding their horns, and
in addition the "brelocque," which is the French
Army "recall" and means that the danger for
the time being is over.
The "Brelocque"
:p=t:
^^-
t
-f • y ^
I
The French "Recall"
25
THE DOCTOR'S PART
This ended my first day on French soiL
Of necessity, my earlier days in the French
capital were given up to adjusting myself to
conditions there, to finding how I might be of
the best use and familiarizing myself with
conditions as they existed in relation to official
life and my chances for obtaining the informa-
tion for which I had been sent abroad.
After about a week I was notified that I
would be received at the War Department as an
accredited representative of our Government, to
be introduced there by our military attache,
who would present my credentials and introduce
me to those who might further my aims in
France.
To any one who has business with the
French War Department the contrast with
our own methods in this western democracy
must be very striking. In Washington, prior
to war days, any citizen of our free republic
had the privilege of walking unchallenged into
the War Department and was only possibly
halted at the door of the office to which he
26
INTRODUCTORY
sought admission. In France things are de-
cidedly different. The War Department in
France, the building in which is housed the
machinery which is running so large and com-
plicated an organization, is unpretentious,
rather out of repair and does not compare at
all with our own ornate building in Washing-
ton. It seems a queer setting for the cunning
genius which is, and has been, directing so fine
an attack and defense against the invading
Hun for the period since 1914.
We were challenged at the gate, a very se-
cure gate, at the entrance to the War De-
partment by a reservist in red "pants" (very
red), with a long mustache (very long), who
scrutinized very carefully the specific written
pass which we had and, after his approval, ad-
mitted us to the labyrinth of dusty winding
stairs, which took us eventually to a courteous
Major of the French service; who chatted very
amiably with the Military Attache and, as I
understood, promised in a general way to afford
us the facilities which were usually granted to
rt
THE DOCTOR'S PART
representatives of a neutral country. From
his office we went to another one, where we
were presented to an equally charming French
Staff Colonel, who renewed the assurances of
good fellowship but made us no definite prom-
ises. In fact, it seemed to be a recognized
part of the game that, while we were to be ac-
corded all courtesies and every possible op-
portunity for the gleaning of information, it
was probable that we could not rely to an ex-
cessive extent on the overtaxed resources
which had other things to do, rather than to
explain to the curious bystander why they were
doing them.
This was my introduction to my duties as
an Observer in France. Added to this, I found
that it was difficult for me to understand the
rapid, careless French of the Parisians and evi-
dently more than difficult for them to under-
stand my best attempts at their own language.
Fortunately, for the sake of my mission and
its fulfillment, in due course of time the rapid
stream of French which at first meant so lit-
28
INTRODUCTORY
tie to me, fell into a more or less orderly se-
quence and I was able to mend many of the er-
rors of my early days, both those of omission
and commission. As an evidence of helpless-
ness during my first experiences in and about
Paris, I might cite my system of getting from
one place to another.
The American policeman is replaced in Paris
by the *'Agent de Police." He is sprinkled
about Paris with about the same frequency as
the American "copper" is in our own cities;
his duties are those of our own police officers,
and his manners are tinged with the true po-
liteness of the French, and if he does not ex-
pect it, at least he appreciates a military sa-
lute, whether one be in uniform or not.
When hopelessly lost, I found that my best
way was to approach one of these dignified
Agents de Police and, in the best French I could
command, ask him for directions in regard to
the place I wanted to go. If he understood me
(which he did about half the time), he imme-
diately launched into a voluble explanation. I
29
THE DOCTOR'S PART
paid no attention whatever to this and let my
mind wander to any extraneous topic: Ty
Cobb's batting average, who would win the
Yale-Princeton game that fall, or anything else
that came into my mind. When he reached
the end of his explanation, however, I became
instantly intent, for at the conclusion of his
directions he was always sure to point in some
direction, and, following the lead of his out-
stretched hand, I thanked him courteously in
French and started off in the direction which
he indicated. After having gone as far as I
considered safe, I hunted up another Agent de
Police and worked the same game on him. In
this way, by what I suppose one might call a
semaphore system, I was enabled always in
broad daylight eventually to work myself from
one place to another. If the condition had
occurred in the night when I could not have
seen my policeman friend, all my knowledge of
spoken language would have availed me little
or nothing.
Realizing my shortcomings in the French
30
INTRODUCTORY
language, a knowledge of which I had
foolishly supposed I possessed when leaving
the United States, I sought quarters at once
with a French family, none of whom had any
acquaintance with English and who were will-
ing to attempt to instruct me in the intricacies
of French as it is spoken in Paris. The ac-
quisition of French under such circumstances
is not entirely a bed of roses. Sanitary im-
provements in France are not on an equal plane
with those to which the average American is
accustomed. The French find no dilBculty in
keeping their houses at least as warm as the
temperature outdoors ; beyond that, they seem
to have no particular interest. The house in
which I lived during a severe winter had no
heat in it with the exception of a gas fire in
the kitchen to cook with and was guiltless of
any bathing facilities. When one felt the ne-
cessity of a bath, there was always the French
public bath establishment available for a cer-
tain, not excessive, fee.
I know many people who cheerfully state
31
THE DOCTOR'S PART
that if they went abroad they would imme-
diately seek quarters of this kind in a French
family and learn French. I doubt very much
if they understand what the whole thing means.
To be a guest with people, who, although
kindly, considerate, interested and thoroughly
sympathetic, have a different viewpoint in re-
gard to almost everything, makes the situation
a little trying. In addition to this, to be in
an atmosphere which is murky with an unknown
language which is constantly dinned into your
ears, leaves one's brain tired and fagged be-
yond expression at the end of the day.
My good landlady used to come in and talk
French and read French to me in the morning
while I had my early coffee. She captured
me at noontime and talked French to me all
through my midday meal. On any of my free
days she appropriated me to go with her to
points of interest in Paris and to listen in the
meantime to the rapid flow of very perfect but
badly understood Parisian French. I went
to the theater with her on my free evenings. I
S2
INTRODUCTORY
met all her friends who came to call on her. I
was taken to call on all her French friends and
by them, in turn, upon all their friends. None
of them spoke any English. I lived in a be-
fuddled atmosphere of a language in which I
was constantly groping and never sure of mj
meanings. I made mistakes, they misunder-
stood what I wished to say, and, all in all, it
seemed a most discouraging proposition.
I remember one or two despairing occasions
when I had been all day battling to keep my
chin before this French flood, when on my re-
turn from some French excursion of this sort
I made a plea that I had collars to buy or a
friend to see and my last ray of hope was
choked off by the cheerful assurance of madame
that she was not at all tired and would go
with me.
The above is not a complaint, but merely
a suggestion that the acquisition of a practical
working linguistic knowledge which one as-
sumes that he has, may not always measure up
to the standards which he has set for it.
3d
CHAPTER II
GENERAL SANITARY SERVICE OP THE FRENCH
I SUPPOSE at the present time there is no
doubt in the mind of any one in the civilized
world that the Germans in 1914 were the most
perfectly prepared of any of the nations for a
state of invasive warfare. The French were
prepared, but still in the midst of many im-
provements in the perfecting of their war ma-
chine which had not been brought up to date.
Along with other things, the Sanitary
Service of the French was still in a condition of
transition. By "Sanitary Service" I mean the
whole measure of the French for caring for
their sick and wounded, the same thing which
is covered in our own service here in America
under the direction of our Medical Depart-
ment. In 1910 a decree had been issued by the
French making decided changes in their Sani-
GENERAL SANITARY SERVICE
tary Service, and when the war broke out in
1914 these changes had not been thoroughly
incorporated into their system of army organ-
ization. Of necessity on this account there was
a certain amount of initial disorganization in
the care of those wounded or sick amongst the
army forces in the early period of the war.
To give some idea of what the French Sani-
tary Service, the organization that cared for
their wounded, covered, it might be well to un-
derstand some of the arrangements the French
made for this purpose during times of peace.
Of course every one knows that all French
subjects are liable to military duty, obligatory
military service. All France in times of peace
is divided into "regions" — there are 21 of these,
all told, in the Republic — 19 in continental
France proper and 2 in Morocco and Algiers.
During peace times each of these regions is oc-
cupied by a French Army and military com-
mand is vested in the commander of that army.
During times of peace certain precautionary
measures are taken through the Sanitary de-
35
THE DOCTOR'S PART
partment in each of these regions. That is to
saj, the French have looked forward to a pos-
sible invasion of their country ever since the
irar of 1870 and have been shaping their af-
fairs by the light of that occurrence. The
sanitary matters in each of these regions were
organized partly under the strict supervision
of the regular medical department of the army
and partly through the intermediary assistance
of the French Red Cross.
At the time of mobilization the command of
these regions passed from the commander of
the mobile army, who went with his forces, and
was delegated to an officer of the reserve or
one who was beyond active military age, and
upon his shoulders fell the responsibility for
the putting into operation of the measures in-
stituted in times of peace for the care and
reception of wounded which might result from
the war.
This meant, in fact, the selection in each
region of a certain number of buildings, schools,
where available, and large pubhc buildings, or
36
GENERAL SANITARY SERVICE
anything of that sort which would be readilj
adapted to the care of the sick, and the draw-
ing up of plans leading to their rapid trans-
formation for the purpose intended. In addi-
tion to this, the Red Cross undertook to fur-
nish a certain amount of supplies for the main-
tenance of these hospitals, and they were stored
in each district, although not necessarily in the
hospitals themselves.
In regard to personnel, the medical person-
nel from the standpoint of the Red Cross was
practically nil. This can be readily under-
stood when we consider that France was living
under a system of compulsory military serv-
ice. All men of military age, whether medical
men or otherwise, were subject to draft on the
mobilization orders issued at the commence-
ment of hostilities, and this left no opportu-
nity for any surplus personnel of a non-military
type to be used to man these hospitals. On the
other hand, the Red Cross Societies trained
and educated a certain number of women who
were competent, to a limited degree at least,
37
THE DOCTOR'S PART
for the duties of nurses. All this was France's
reserve in event of just such an occurrence as
the invasion by Germany in August, 1914.
As I have stated before, this organization
was not completed at that time in accordance
with the decree of May, 1910, and in the early
days of the war there was undoubtedly much
hardship due to this fact. As time went on,
the French realized that the conflict was not a
matter of months but one of a considerable
length of time, the various defects were reme-
died, the sanitary machine and personnel ham-
mered into shape and brought to work with the
most excellent efficiency which characterizes it
to-day.
For instance, after the battle of the Mame
in September, 1914, there was lacking trans-
port by train, by horse-drawn vehicles, and
most notably by automobile transport. There
were not nearly sufficient hospitals to receive
and care for the large number of wounded which
came from the battle of the Mame and the
French retreat preceding this. As a natural
38
GENERAL SANITARY SERVICE
consequence, there was much improvisation and,
as would naturally be expected, this makeshift
method did not stand the test and gave very
evident proof, not only to the Medical Depart-
ment itself, but to the generality of France,
that rapid improvement in the whole system of
caring for the sick and wounded was a very
imperative necessity.
France took this matter very seriously, as
was indicated in the report of a High Com-
mission authorized by the Chamber of Deputies
and commonly known as the "Reinach" report,
which, by the way, forms very interesting read-
ing in regard to this subject.
Dating from this period, conditions in re-
gard to the care of sick and wounded fell into
more orderly lines, and errors in the assignment
of personnel and the utilization of various vol-
unteer organizations were more clearly classi-
fied, and the whole system was put upon a more
orderly basis.
The French had at this time, that is to say,
after the battle of the Mame, found the ne-
39
THE DOCTOR'S PART
cessity of sending a great number of their
wounded far into the interior to be taken care
of by the volunteer organizations already re-
ferred to. They found from actual experience
that in this practice one of two conditions ex-
isted. Either the men did not receive the pre-
cise and careful treatment that they needed,
or, through an excess of sympathy, they were
over-treated and were held at the rear for a
longer time than was necessary, so that the
fighting forces at the front were unnecessarily
deprived of the services of men who should
have been returned long before the period of
their actual arrival.
A French medical officer, in commenting on
this situation to me, remarked: "The armies
melted like snow and many who were furloughed
to the interior disappeared like rabbits in the
underbrush." It is unnecessary to say that,
after a short experience of this kind, the French
realized that some more practical method had
to be evolved, and this was the beginning of
40
GENERAL SANITARY SERVICE
the present workman-like system which leaves
very few able-bodied men unaccounted for.
With the present system I think it is safe to
say that the most important thing in the sani-
tary scheme is that comprised in the French
word "triage," which means "sorting." Yoh
hear it everywhere in connection with the oper-
ation of the service, and in addition to being a
method of classification, it is a careful and con-
tinual check on the movement of the wounded
and disabled. After the experience gained by
sending the non-effective back into the Zone of
the Interior, the French cast about for a more
logical method of caring for them. It was
decided that the best thing for both the State
and the individual was to shorten as much as
possible the time between the receipt of the in-
jury and the curative means employed. The
percentage of recoveries was higher when
wounds were treated within some hours after
their infliction than if days intervened, and in
this way lives were conserved not only for the
benefit of the individual, but to the advantage
41
THE DOCTOR'S PART
of the army as a further addition to the fight-
ing force. In the second place, it minimized
very much the evil of absenteeism which I re-
ferred to and which at one time was a serious
problem for the French to face.
The outcome was that the majority of the
cases were held in the Zone of the Armies and
there, under direct Military authority, they
were not lost nor delayed in their return to their
organizations. With this idea the various
units of the Zone of the Armies were developed
and built up. The Evacuation Hospitals came
to be, in part at least, true hospitals and not
merely forwarding points. The Ambulances
of the First Line took more formal care of the
wounded than before, and throughout the Zone
of the Armies the Surgical centers were de-
veloped and in them patients were grouped who
would have been scattered under the old system
throughout the Zone of the Interior.
I spoke a few pages back of the part which
the French Red Cross plays in the care of the
sick and wounded. It seems to me that there is
4S
GENERAL SANITARY SERVICE
here, in the United States, a good deal of mis-
understanding as to the real function of this
society during time of war. With the French it
is almost exclusively employed in regions other
than of actual conflict. The Red Cross nurse in
the poster, she of the winsome face and spotless
uniform liberally adorned with the insignia of
the society, caring for a wounded man amid a
hail of shot and shell, is, as a matter of fact,
replaced by some hairy and probably dirty-
faced Brancardier whose military duty it is to
get himself killed if need be while he brings in
his wounded brother of the line. Common
sense would seem to indicate that the fringe of
a battlefield is no place for a woman. I have
no desire to impugn their courage, but it just
is not a woman's job any more than it would
be for them to take rifle and grenade and go
charging forth to attack the opposing lines.
There are some instances where women have
maintained aid posts and rest and comfort sta-
tions close to the lines and they have done the
work well, but the greater part of the duties
43
THE DOCTOR'S PART
whick must be performed on or near the front
lines fall to the hand of man rather than to
tkose of the gentler sex.
As it has been with the French, so will it be
with our own forces, and the adventuresome
and plucky girl who goes abroad with the idea
of work of this character will probably be dis-
appointed. This does not mean that those who
nurse with the army are free from risk, for the
Bodhe, in the persistent idea of undermining
the allied morale, still sticks, and probably will
continue to stick, to the plan of bombarding
and bombing buildings protected by the Red
Cross with the same indifference that he dis-
plays in regard to any question involving right
and wrong. Nurses and medical officers have
beea killed in a number of hospitals under these
circumstances and there is no probability that
any of the Sanitary Units which work within
gun range or easy flying distance of the Ger-
man lines wiU have any immunity from attack.
The determination of the personnel which is
available for the Sanitary Service of the French
44
GENERAL SANITARY SERVICE
is not a difficult matter. No more so than the
determination of the personnel of the Army,
since both are dependent on the law of nniyersal
service.
The Regular — standing — Army of France is
fixed by law at a certain number both as to Ike
commissioned and enlisted personnel, and in the
event of the outbreak of war this does not iM-
crease as such, but remains the same. TTie
increase is made in the personnel which is called
to the colors from the citizens of the land who
have been trained for this duty by the period
of compulsory service and the yearly maneu-
vers. The medical profession has no exemption
(neither has the clergy) from this duty, and
if a doctor is not needed in his own character
he goes to make up part of the combatant
force. As a matter of fact, with the high wast-
age in the Sanitary Service there has been oc-
casion not only for all the graduates in medi-
cine, but the French have made use also of cer-
tain of the medical students who have completed
enough of their work to be of actual service
45
THE DOCTOR'S PART
with certain units in the field. These are termed
the "Medecins Auxiliares," and are of verj real
value in the work of the corps.
In time of peace each man who has com-
pleted his training knows to what provisional
regiment he is assigned and each officer, medi-
cal as well as combatant, has his sealed orders
which he is to open if war is declared and which
will give him directions as to where to report
and to whom. General mobilization orders are
prepared also and are stored in the barracks
of the "Gendarmerie National," or State Po-
lice. When the State decides to call forth the
forces, the necessary data, date and place, etc.,
are filled in at the barracks of the Gendarmes
and the proclamations, or orders of mobiliza-
tion, are all posted throughout the country at
the same time. Care is taken so that these re-
serve regiments are made up of the inhabitants
of the region, and the consequence is that all
who are called are supposed to be at the depot
or place of assembly within twenty-four hours
after the mobilization order has been posted.
46
GENERAL SANITARY SERVICE
As to the medical personnel of a regiment, gen-
erally the senior officer is one selected from the
regular establishment to give balance to the or-
ganization and the others supplied from the re-
serve who come under the mobilization.
In addition to those Medical Officers who are
needed for the care of the Regiments, there are
of course a number who are required for other
organizations. To meet this requirement there
is kept in the office of the Chief of the Sani-
tary Service a list of the Medical persoimel
which is available and from it is drawn the num-
ber required -for extra-regimental requirements.
In this reserve army there is no limit ; those
who are needed are called and on the cessation
of hostilities they revert again to an inactive
status. The effect is that every able-bodied
man in France is a potential defender of the
State and that he must stand ready to drop all
else and give his services to the common need.
The education of these Reserve Medical Offi-
cers is that which is acquired by any prac-
ticioner of medicine plus the term of required
47
THE DOCTOR'S PART
tervice, three years with the colors. Under
these conditions any man called from civil life
has the advantage that he does not go from
the paths of peace to the ways of war with only
a hazy idea as to what the duties of a soldier
are. He has had, so to speak, a magnified
Plattsburg and comes to the ways of the serv-
ice with less timidity and more confidence than
if it were altogether terra incognita. For the
Medical Officer of the Regular Army admis'
sion is by way of the schools at Lyons, or else-
where. The young man who decides to make
Military Medicine his career matriculates at the
Medical School at Lyons and takes the same
courses there as do his civilian brothers, but in
addition to this he has extra work given by the
Military Faculty in the same place and he lives
during the time of his study under Military
control.
This school is organized to train five hundred
or more students and the proportion of ac-
cepted candidates is generally about 10 per
oeait. The applicant for admission must be un-
48
GENERAL SANITARY SERVICE
3er twenty-four years of age, the possessor of
a Baccalaureate Degree and have had one year
in a recognized Medical School. If accepted
after physical and mental examination the stu-
dent receives the grade of "Aspirant," which
is equivalent to a warrant grade. After admis-
sion to the school he is assigned to a Regiment,
usually Cavalry, as a private, and serves there
with no medical function for one year, after
which he returns to the school and takes up his
professional work. The course is three years in
duration and the work is intensive. Those who
pass the examinations are commissioned as
second-lieutenants after they receive the Medi-
cal Degree and are then sent to the Military
Hospital, Val de Grace, in Paris, where they
receive practical instruction for eight months
and are then assigned to regiments and ranked
in accordance with their standing. Promotion
to the grade of first-lieutenant is automatic
after one year, or four months after the course
at Val de Grace, and relative standing is de-
pendent on the grading in the final examinatiom
4d
THE DOCTOR'S PART
in this hospital. Promotion thereafter is bj
selection rather than by seniority, but no one
can skip a grade and, unless an officer has shown
some unusual aptitude or brilliance, it is not
usual that he be advanced over the heads of
many above him. There are authorized one
thousand Dentists, who are not commissioned,
and the Army Nurse Corps is fixed at one thou-
sand also. There is agitation to increase the
number of Dentists and naturally the number
of nurses is entirely insufficient to meet the de-
mands of war-time conditions.
The direction of this service lies in the hands
of a civilian who is a member of the French
Cabinet. He is titled the "Under Secretary of
State for Sanitation," and in spite of the "Un-
der" in his designation he is practically autony-
mous in his position and his decisions in his own
Department carry authority. Prior to the war
one of the General Officers of the regular Medi-
cal Service held this position, and at present
two of them act as aids to the Director. I think
it is doubtful as to whether the change in direc-
50
GENERAL SANITARY SERVICE
tion has been a gain and that it is problematic
as to whether the system does not sooner or
later revert to its first status. The head of all
the service centers with the Director in Paris
and branches throughout the different armies
and regions which are affected.
The Service of Supply, as well as that of
replacement of personnel, is based on the plan of
echelon and a marked feature is the numerous re-
serves of both men and material which are main*
tained at various points in the chain which
stretches from the Interior to the ultimate limits
of the fighting line. It simplifies the system of
supply, for all that is required of any supply
depot under this system is to see that the supply
in the depot is kept at the normal level, and each
one calls on the one behind it to replenish what
has gone on to the unit in front. Thus, the
Brigade supplies the Regiment and draws on
the Division for replacement ; the Division, after
supplying the Brigade, depends on the Army
to refill its stores and so back to the Central
supply Depots in the larger cities of the Zone
51
THE DOCTOR'S PART
of the Interior. This obviates the necessity
lor the repeated transfer of requisitions and the
chance of delay due to congestion in traffic or
delay in approval or other usual causes. It
is simple and effective.
It is difficult to give in so brief a space any
adequate idea of the complexity of the ma-
chinery which is evoked in the care of an army
nnder field conditions. We must understand
that it is not only the question of caring for
the wounded man. That is the apex of the
pyramid, the object of the entire procedure, but
as we multiply the one man by "X" the pyramid
descends to its base with a wide angle and we
find that many questions which do not at first
occur to us have to be considered. Transpor-
tation, supply, records, construction, feeding,
preventive medicine and many other things fall
in line to make up the perplexing whole. And,
withal, everything must function with a certain
degree of smoothness and be fairly automatic,
for unless the wastage is promptly and care-
fully made good there will not be fighting men
52
GENERAL SANITARY SERVICE
enough to carry on and the State will have to
divert too much of its energy to the care of
its non-efFectives.
As an evidence of the magnitude of the task
which falls to the lot of the Sanitary Service
in war, I may state that in one operation wliich
lasted for three days the casualties were esti-
mated at 90,000. A proportion of these were
killed, to be sure, but even that involved duty
in burial and in completion of the records, and
the remaining fraction leaves us with the im-
pression that although it is a tremendous task
to maneuver in battle large masses of troops,
it is by no means easy to collect and put in
shape again those who have fallen in the at-
tack.
The accompanying diagram shows graphi-
cally, and in a general manner, the path fol-
lowed by the wounded man from the first line to
whatever point he be destined. The work of the
front line trench is carried out by the Regi-
mental personnel, both Commissioned and en-
listed, and this personnel is aufirmented by the
63
THE DOCTOR'S PART
band, pro^dded there be one In the Regiment.
The duty of the Regimental personnel is fin-
ished when the wounded are delivered to the
First Aid Post, which has its own personnel
for the care of the cases which come to it. The
route of the wounded soldier from this point
may be by several means of transportation. If
he is to be carried by hand, this duty is taken
up here by the Divisional Group of Litter
Bearers, which is distributed in accordance with
need by the Division Surgeon. He may go di-
rect to the Automobile Surgical Ambulance if
he is a bad case, or he may be taken to one of
the Ambulances of the first line to be shifted
possibly from there to the unit just referred to.
If able to walk, his problem is simplified and he
makes his way on foot. In certain instances
it is possible to evacuate the first aid posts by
automobile direct, and sometimes when it is not
possible for the automobiles to approach the
Post, a Collecting Station (not shown in the
Diagram) is established in a sheltered position
in the rear of it and the wounded evacuated to
54
Q.yMbul*ne&
tl
o
C
,^ "lif- Line Am6.
C2Ti>v6M7a.Tice5 j^
Ovpoh of. ■ ^
Jr«i J
M tfctp, fcJ Center^
^±1 \ 1 1 I I I 1 !
rTetnporary "Temp, H»mp,
Oxtt. Hoi p.
Hosp
CLior. Ho%p,
Diagram Illustrating the Routes of Evacuation op
THE Wounded from the Front Lines to thb Zones
OF THfl Interior.
55
THE DOCTOR'S PART
it by hand litter and there picked up by the
automobiles. It is not unusual in a busy sector
to keep an automobile constantly stationed at
such a point to take care of those who need
inmiediate transfer. It must be remembered
also that all the units of the trench line system
are intimately connected by telephone, and that
it is not a difficult matter therefore to call for
transportation when required.
The automobiles which are charged with this
duty of evacuation are furnished by one or more
sections which are ordered to certain sectors for
duty in accordance with the intensity of the
action. A Section consists of twenty cars and
the capacity of the cars runs from three lying
cases for the Ford type to five in the latest type
of the French ambulance with the Kelner type
body. With the capacity known and the mile-
age to be covered in the run and the average
speed possible, a pretty accurate estimate can
be made as to the time necessary for the evac-
uation of any number of wounded. The Firs*
Line Ambulances may retain their mobile func-
56
GENERAL SANITARY SERVICE
tion and serve merely to care for the wounded
until they are taken to units further in the
rear, or they may become fixed, the "Ambulance
Imobilizee" in French terminology. To accom-
plish this latter end a supplementary section,
known as the section of hospitalization, is sent
up from the Divisional reserve and added to the
mobile ambulance. It comprises both addi-
tional personnel and materiel and serves to
transform the mobile unit, with its compara-
tively meager equipment, into the equivalent of
one of our Field Hospitals.
When the necessity has passed, this reinforc-
ing personnel and materiel is returned to the
Division reserve and the Ambulance reverts to
a mobile status again. The Automobile Sur-
gical Ambulance and the first line ambulances
send cases to the Evacuation Hospital, which
may be at a Railhead and must of necessity be
on a railroad. These Evacuation Hospitals
are made up of two sections, either one of which
may function independently, or both combine to
make up a more formal organization. If they
57
THE DOCTOR'S PART
function separately, their province is more
that of a collecting and sorting point than of
a Hospital proper. I have spoken of this in
preceding pages, and of the important part
which these hospitals now play in the Sanitary
scheme.
At the Evacuation Hospital, of whichever
type it be, the wounded are disposed of in one
of several ways. If there is a hospital section
attached to the Hospital, they may be trans-
ferred to it for treatment until they are in
condition to be sent back to their units again.
There may be a Hospital Center in the neigh-
borhood, and in that event they may be trans-
ferred by automobile to one of the hospitals
which compose it. There are usually one or two
Ambulances in the neighborhood also which can
care for a certain proportion of cases. In con-
nection with this hospital there is also a Depot
of Convalescents and "Eclopp^s," as the French
call those who have not much the matter with
them. This Depot serves to relieve the hospital
of those who are well enough to dispense with
58
GENERAL SANITARY SERVICE
formal care but not yet strong enough to go
back to active service. In addition to this there
is at each Evacuation Hospital the materiel
and personnel to make up two Sanitary trains.
At this Hospital the Sanitary trains are load-
ed and routed to their destinations. There is
usually a daily train, and in times of activity
the number increases. These trains are made
up so that there is the minimum amount of
transfer of the wounded carried by them. So
far as possible trainloads are made up to go
entire to some definite point and thus it is not
necessary to break out cars for different points
nor to disturb the wounded until they have
reached the point of final debarkation. This
simplifies matters considerably, and makes for
the comfort and well-being of the wounded. Be-
fore a train is started word is sent to the point
to which it is routed and arrangements are
made there to meet it at the hour specified and
to dispose of its load in accordance with the
number of vacant beds in the hospitals of the
Region. The Director of the Line of Com-
59
THE DOCTOR'S PART
munication is kept constantly informed by the
Surgeons in charge of the different hospitals
and Regions of the number of available beds in
each one so that in routing his trainloads of
wounded he knows exactly what he can count
on in the way of resources in any one place.
This system has grown up with the experience
in the transfer of wounded and is a long step
ahead of the rather crude and somewhat hap-
hazard method which prevailed at the outbreak
of hostilities. The wounded shipped by train
to the interior are inspected at various points.
Particularly at the "Gare Regulatrice," or Reg-
ulating Station, which usually is at the junc-
tion of the Zone of the Armies and the Zone
of the Interior. It is the duty of the Medical
Officer in charge at this point to see that no
case goes beyond it which should be retained
in the Zone of the Armies and that those who
are forwarded are in proper shape for the
journey. Now that the Sanitary Trains are
more formal in character and manned by an ex-
perienced personnel this duty is less exacting
60
v.
^, ^ ^ A«|
r*
Red Cross Nurses at a Railway Station Canteex Giv-
ing Coffee to the Wounded.
Tent Wards, Showing One of the Type of Tent Used
BY the French.
GENERAL SANITARY SERVICE
than when the Regulating Station stood as the
real check on what had been done at the point
farther forward.
On the line of Railroad at appropriatelj
spaced intervals are Railroad Rest Stations
and Railroad Canteens. Stops are made
at these and the wounded fed and ex-
amination made of their condition. These can-
teens are in charge of the Red Cross and the
feeding is quickly and systematically done so
that there is little delay in the progress of the
wounded. A train may be diverted to one of
the Regional Hospitals, or group of Hospitals
as shown in the Diagram, or it may continue
to a large town which is a center for a number
of Hospitals where there is provision for not
only general care of the wounded, but for the
various specialties which may be needed by in-
dividual cases. In addition to the two Zones
listed in the Diagram, there is another known
as the Zone of the Line of Communication.
This comprises the Railroad and the adjuncts
to it. That is to say, the right of way, the
63
THE DOCTOR'S PART
TarioiLi Rest Stations and Canteens and the
Hospitals which are connected directly with it.
The administration of this Zone is an irapor-
tant post and upon the efficiency of the Director
depends to a large extent the smooth function-
ing of the service further to the front. It is
presided over bj a General Officer and he has
hig staff which includes a Chief Surgeon and
yarious Inspectors who are charged with the
duty of seeing that all measures dealing with
the care of the wounded and sick are properly
performed. This includes not only the ques-
tion of transfer, but that of supply of pei^
sonnel and materiel and the maintaining of
proper reserves at the designated points.
The diagram does not show the full com-
plexity of this service in the Zone of the Line
of Communication, for there are many minor
points which, while essential to the proper func-
tioning of the whole, are too much a question
of detail to be brought out in a general scheme.
A little thought will make evident what they
are: the question of the channels of the vari-
64
GENERAL SANITARY SERVICE
ous orders, which secure an orderly correlation
of the various fractions which go to make up
the whole ; the maintenance of the railroad sys-
tem which is charged with the transfer of the
wounded ; the provision of the proper quota of
rolling stock for this end in each part of the
combatant area; the management of the auto-
mobile and horse-drawn transport; the assign-
ment of personnel to the various units. These
and many more go to make up a problem which
requires careful and intelligent handling to en-
sure good results.
We, on this side of the Atlantic, hare
been rather prone to plume ourselves a
good deal on our superiority in the
matter of Rail transport and to look on the
Continental system as perhaps inferior to our
own. Shortly before I left France something
was brought to my attention which made me
doubt whether this supposed superiority of ours
was in reality so very marked. It became nec-
essary to arrange for the transport of a large
number of troops and the movement was to be
65
THE DOCTOR'S PART
executed with as little delay as practicable.
Word was sent by the Director of Railways to
the Greneral Manager of one of the Railway
systems, stating the requirements and asking
how soon the Company would be able to start
trains, what headway they could be run at after
they had started and for how long a period the
service could be maintained at that, the maxi-
mum rate. The answer came back very
promptly that the Company would be ready to
start the first train in three hours, that after
the first train had left they would run others
with half an hour's headway, or as fast as they
could be loaded, and that they would maintain
this service and schedule as long as was neces-
sary. The Company not only made this state-
ment, but they lived up to it. It seems to me
that when we consider that this was done in a
country in a state of war and with necessarily
depleted equipment, we might consider it as a
very creditable piece of railroading not only
for Continental France, but for our own coun-
try.
66
GENERAL SANITARY SERVICE
The Sanitary Train has been a source of
some embarrassment for the French. The Euro-
pean type of car does not lend itself well to the
purpose, and they have been obliged to exer-
cise a good deal of ingenuity to meet the situa-
tion. The Continental "carriage" is short,
about half the length of our regular passenger
car, many of them have separate compartments
opening with side-doors and no communication
one with the other. The use of this type has
the disadvantage of interrupting communica-
tion through the train which is a serious objec-
tion for a service of this kind. Some of these
cars have been adapted by the use of special
apparatus and with telephone connection, but
the more practical type is the baggage car,
which in addition to the side-doors has an end
door also which does away with the bad feature
of the other class. There are several trains
made up of the long baggage cars of the Inter-
national Type which run on the Expresses
from Paris to Nice, and these easily lend them-
67
THE DOCTOR'S PART
selves to the required purpose but are too few
in number to take care of all the traffic.
Any attempt at description of the various
phases which go to make up the complex whole
of this system of care of the sick and wounded
must inevitably lead one through a maze of de-
tail. Each step carries one to a fork where
the subject branches and each branch further
subdivides until one unexpectedly finds himself
perched on the ultimate twig and perhaps far
from the object which he set out to pursue.
The rather brief summary which I have at-
tempted will, I think, serve to show the magni-
tude of the task, and the thought and patient
care which has been exercised in working out
and putting into operation the present system
which, while probably susceptible of further
refinement, is still wonderfully efficient in the
care of large numbers of helpless men.
CHAPTER III
HOSPITAI.S OF THE INTERIOE
Ceetain terms have by constant use come to
have an accepted and clear meaning to those
who are engaged in the serious game of war on
the other side of the Atlantic.
Our interest in the affairs "over there" has
brought a knowledge of these terms overseas
to many of us, but it may not be amiss to state
in a general way how the territory of France
is divided for the time and uses of war.
To begin with, there are two general divi-
sions. A line is drawn, not in accordance with
any fixed geographic boundaries, but in ac-
cordance with the exigencies of the situation,
and all territory on the side nearest the enemy
constitutes "The Zone of the Armies." That
behind this is the "Zone of the Interior." While
all France is really under Military control, the
69
THE DOCTOR'S PART
Zone of the Armies is the special province of
the Military. All entrance into it, all exit from
it and all movement in it is governed and sanc-
tioned by the "Grand Quartier General," or
Great General Staff, which is presided over by
the "G^neralissime," or Supreme Commander
of the fighting forces ; at the present writing,
General Foch. Incidentally, that name is pro-
nounced "Fosh," with the o long as in "Oh."
This Zone of the Armies has other subdivisions
which will be spoken of later.
The Zone of the Interior comprises the rest
of the country that is not needed by the active
War Lords and is presided over by the Civil
authorities so far as ordinary matters go, and
by the IVIinister of War when it comes to a
question of strictly Military jurisdiction.
In tliis Zone of the Interior are the ultimate
repair shops for the damaged human machines
that have been put out of commission at the
front. They filter back to these just as pow-
ders are graded through a series of sieves of
varying mesh and it results that only the very
70
HOSPITALS OF THE INTERIOR
severely hurt (from an economic point of view)
come to them.
By this I mean that when there is any prob-
abihty of returning a soldier to the firing line
as an effective within a certain length of time
he is held within the Zone of the Armies, at
one of the large Hospitals there. When he has
lost a leg, an arm, or is otherwise permanently
disabled, or when his cure must take more than
the allotted time, he goes back to the Zone of
the Interior and is placed in the Hospital best
suited to his particular needs.
Three years of war have made a vast dif-
ference in the orderly disposition of cases as
well as in other matters and now the French
have in addition to their general hospitals a
chain of others fitted for the treatment of all
sorts of specialties.
There are fracture hospitals, hospitals for
head cases and brain surgery, those for the
burned, for nervous diseases and a host of
others, and in this way each man is assured of
coming under the charge of the practitioner
71
THE DOCTOR'S PART
who makes a specialty of caring for his par-
ticular malady or injury instead of carrying
it as a "side line" with his general work.
These hospitals are now carefully organized
and under strict Military control. After the
battle of the Mame, when the French were
swamped by the wounded, they had to make
use of every facility and the consequence was
that a good many private hospitals were opened
by well-meaning but not always responsible peo-
ple and that the army suffered in consequence.
In some the care was not all that it should have
been and in others the lack of discipline and
careful check resulted in the loss to the fight-
ing force of a very appreciable number of men.
Realizing this, the French shut out these pri-
vate institutions and recognized only those
which were under the three authorized Societies
which go to make up the French Red Cross.
With this innovation things moved in a more
orderly manner and to-day the progress of a
wounded man is no longer a matter of con-
jecture and his location and condition are
72
HOSPITALS OF THE INTERIOR
known at all times to the War Department.
One of the Hospitals of this class which, while
not a large one, must always be of interest to
Americans, is what was formerly the Ameri-
can Ambulance Hospital at Neuilly, a suburb
of Paris. This was started in the early days
of 1914 by Americans then resident in Paris.
It was situated in a school building which at
that time was just completed and grew from
modest beginnings to an institution of some
700 beds.
In addition to taking care of the wounded
it served the admirable purpose of training
many young medical men in the new surgery
which this new method of conflict has made es-
sential. In it our Yankee specialty of Den-
tistry took on a new dignity and under the able
leadership of Doctor Hayes in conjunction
with the Surgical service, some very wonderful
work was done, and is being done, in the res-
toration to a semblance of something human
those suffering from the terribly disfiguring
wounds of the face.
73
THE DOCTOR'S PART
It is a little difBcult in the quiet walks of
peace to realize just what can happen to a
man's face as the result of shell wound and still
leave him alive. Alive, but a living horror to all
who see him and he himself, a despondent
wretch. If you can figure to yourself what a
man is with no nose, with no lower jaw, or only
half a one, with a face that looks like a man-
gled beefsteak, you can appreciate what it
means to patiently build him up again almost
from the beginning and turn him out, scarred
and seamed to be sure, but not an object that
children would run from screaming. It is a
work that calls for infinite patience, both on
the part of the operator and the wounded man,
for this is not done at one fell swoop, but means
many weary months and sometimes as many as
twenty or thirty operations. They borrow
pieces of rib and bits of shin-bone and make
new noses of them; they twist and pull and
coax adjacent tissue until it covers the gaps
and they bridge in vacant areas by skin grafts
until finally the unfortunate wretch comes forth
74
HOSPITALS OF THE INTERIOR
somewhere in the shape that God made him. It
is the very antithesis of war ; an upbuilding to
meet a tearing down: construction versus de-
struction, and is a work that any member of
the profession cannot but regard with pride.
I had been one day at one of these interest-
ing if sanguinary operations and at its coik-
clusion went into one of the "face wards" to
see the progress in a case which I had seen oper-
ated on some time before.
In one of the beds, splinted and bandaged,
I noticed a cheerful looking mulatto, with the
French War Cross on the left breast of his
gray pajamas. His white teeth flashed in
laughter, and he was chattering away in rapid
"Poilu" French to his neighbor, a youngster
who looked as though he might have come from
the South of France — the "Midi"— that land of
sunshine and fair skies — the country of "Tar-
tarin of Tarascon."
Of course it is absurd, but I think we of the
United States are apt to assume that all the
Sons of Ham are compatriots of ours. We do
75
THE DOCTOR'S PART
not quite realize that France's colonial hold-
ings have given her also a proportion of the
dark aliens. Anyhow, the brown-skinned sol-
dier looked so much like home that, after wan-
dering by his bed several times, I wheeled on
sudden impulse and, standing at the foot, said,
"Boy, what's your name?" He ducked his
woolly head and with a flash of teeth, chuckled
in a tone that meant some place south of Mason
and Dixon's line, "Sam Brown, suh, Sam Brown,
tha's ma name."
I walked around and sat down in the chair
between him and his French neighbor and con-
tinued my investigations. "For the love of
Mike, Sam Brown, where did you come from,
how did you get here and what are you doing?"
"Me, Major? Ah come fum Galt;^5ton,
Texas." (I knew he did, or he would not have
put the accent there.) "Come ovah on a cahgo
boat, 'bout a yeah and a half ago, and I 'listed
up with the French ahmy and I'se a sho-nuf
Poilu now and they done give me the Croix de
Guerre. Yas, suh, I'se a French soldier."
76
HOSPITALS OF THE INTERIOR
And I told Sam Brown that I had been sta-
tioned in his Galveston when I got my order
to come and see what he and the other French
poilus were doing, and we chattered of people
there, and he told me how he was wounded on
the Somme ("Sum," he called it), and the lit-
tle French neighbor from the Midi chipped in,
and we gossiped away, sometimes all three in
French and sometimes just Sam Brown and I —
two soldiers from the Great Republics — in plain
American, not English, and the little French-
man from the Midi told me what a good "Co-
pain" Sam Brown was, and Sam returned the
compliment, and we three had a delightful
twenty minutes. I left them money for cig-
arettes, wished them both "Bonne chance" and
left as Sam Brown assured me, "Ef you hadn't
a spoke to me, Majah, I should have spoke
to you, 'cause even if I is a Frenchman, that
unifohm looks mighty good to me."
In answer to my inquiries, they told me that
Sam Brown was a brave soldier and a cheer-
ful patient.
77
THE DOCTOR'S PART
That is one of the saving graces of these
#ollections of maimed and injured men — al-
ways somewhere in the atmosphere of pain pa-
tiently borne, of suffering endured without a
cry — there is a rift in the clouds, and the sun-
ghine of human interest, of gentle comedy
breaks through to turn to gold for a minute
the red stains on the bandages.
It is not hard to learn a lesson in cheerful-
ness from these wounded men, and I can think
of no better cure for the man or woman who
deplores his luck than to watch some man
lopped of an arm or a leg, as he patiently
tries to make the best of his artificial substi-
tute and with a cheerful grin swears queer
good-natured soldier swear-words, both at its
stubbornness and his own clumsy efforts.
Suppose, Mr. Man, that the next time you
jire peevish because James has left a bit of shell
in your breakfast egg, you figure on what it
would mean if you had no James — only an
awkward left hand and arm to do his job.
I think one of the best examples of the un-
78
Mutilated Soldier Learning to Engrave with an
Artificial Hand.
Soldier with Double Amputation of the Arms, Show-
ing How ]\IucH May Be Accomplished with the
Artificial Hands.
HOSPITALS OF THE INTERIOR
failing spirit of these wounded men was at th«
"Hopital du Pantheon" over on the left bank
of the Seine in Paris. It was in the old quar-
ter and in a building that had for many years
been used for Hospital purposes.
I was invited there by a surgeon renowned
for his skill in surgery of the head. The case
was a man who had been wounded by a high
explosive shell and had a fragment of the sheU
casing in his brain, in the middle line and about
halfway from forehead to the back of his head.
As a consequence of this unsought intruder he
was developing a paralysis of arms and legs
and it was considered essential for his well-
being that the fragment be removed.
He was a husky peasant, and aside from the
halt in his gait as he entered the operating
room and the look of embarrassment at the
sight of the medical men there assembled to
see his operation, there was little to differ-
entiate him from the average "Poilu" one sees
on the Boulevards of Paris. Due to the fact
that this was an operation on the brain he
81
THE DOCTOR'S PART
did not have, in his ordeal, the benefit of ether
©r chloroform. It was, with the exception of
the physically deadening effect of the cocaine,
what one of our leading papers would denounce
as "vivisection."
He came into the operating amphitheater
with proper dignity, was seated at the end of
the table on a stool, his head bent forward and
lest in a moment of uncontrolled nervousness
he might rebel, his wrists were lashed and he
bowed his head forward on the table.
The whole thing was done under local anaes-
thesia (cocaine or one of its derivatives) and
he was entirely conscious during the whole
time of the operation. This consisted in open-
ing the skull, cutting through the membranes of
the brain and then extracting the fragment of
ahell which had been the cause of his trouble.
This fragment was in the brain itself. He
was perfectly cognizant of what was going on
during the entire time of the operation, but he
never moved: whether he was in pain or not,
no one save he himself knew. When everything
82
HOSPITALS OF THE INTERIOR
yras completed and he raised his face, streaked
with the blood which had run down from the
wound in his scalp, the first thing he did was
to turn to the Surgeon who had operated on
him and say with steady quiet courtesy, ''My
Doctor, I thank you a thousand times." A
little later he walked, serene and unshaken, back
to his ward and his bed. It seems to me a
hard task to beat down a National spirit which
is made up of such men as this, and he was by
no means exceptional in his quiet fortitude. I
am glad to say that he made a perfect recov-
ery and has probably long since gone back to
that Hell of the front lines, there to do his bit
and wait what fate shall bring him.
I spent three weeks in another hospital in a
little town not a great way from Paris, on the
Seine, where almost all the work was that of
the treatment of fracture cases. "Fracture" —
a broken bone, brings to most of us the picture
of a distorted limb, but not as an invariable
accompaniment, torn and mangled flesh as well.
Fracture as the result of artillery fire means
83
THE DOCTOR'S PART
always this damage to the flesh and almost in-
variably an infection of some sort. And just
as the fracture itself is complicated, so in the
same ratio is the treatment. It needs skill
and ingenuity and patience and a large amount
of that sixth sense which God has given to
women — intuition.
Dr. Joseph A. Blake presided over this
Hospital and in his constant dealing with this
class of injury had evolved an ingenious and
most efficient system of splints and suspension
which made for quick and satisfactory healing
and left the patient free of the torture of some
of the older and more cumbrous apparatus.
The wards devoted entirely to the fracture
cases were a forest of uprights and cross-pieces
traversed in all directions by cords running
through pulleys and at the ends of the cords
dangled sandbags and weights like some queer
fruit in this conventional grove. It was known
familiarly as "The Machine Shop" and refer-
ence to the two accompanying pictures bears
out, I think, the aptness of the nickname.
84
Fracture Ward in Blake*s Hospital, Commonly
Known There as "The Machine Shop."
I Mi^^
A Fracture Ward.
HOSPITALS OF THE INTERIOR
The cases which reached this hospital were
of the class I have referred to — those which
were either hopelessly out of the game, or would
require more than the allotted five weeks for
their restoration to duty. It was also a "sur-
gical center." That is to say, the operating
was done in this one hospital save for minor
work, and the cases as they improved were
transferred to one of several others in the vi-
cinity where they finished their course and
were sent either forward for further service, or
back for discharge from the army. I saw here
an interesting case. The man was apparently
shot directly through the heart according to
the testimony of the wounds of entrance and
exit. Yet he walked a mile before he received
his first dressing and recovered after an un-
eventful course. Of course it is possible that
there was one of those curious deflections of
the bullet by the ribs, but even so, and grant-
ing that the heart was untouched, it was re-
markable that the man was able to walk the
87
THE DOCTOR'S PART
distance that he did and that his recovery was
so uneventful.
As in all the hospitals at that time the work
had been systematized so that from the time
of the reception of a wounded man until the
date of his transfer or discharge there was
practically no lost motion.
The wounded for this particular chain of
hospitals were received at , where they
came by train from the hospitals nearer the
line. It was interesting to see the methodical
way in which they were received and distributed.
I went over to the receiving point once to see
the process. A telegram had been received
saying that at such an hour a train of 89
wounded would arrive. This was received long
enough in advance to make it possible to deter-
mine as to what proportion of cases should be
sent to each of the hospitals of the group and
the various ones were notified that they would
be called on that afternoon to receive so many
wounded men. At the appointed time the am-
bulances of the group were at the station and
88
HOSPITALS OF THE INTERIOR
Blake and other representatives to make the
apportioning. The train was a "permanent"
Sanitary train, made up of the short conti-
nental box cars, each one fitted with apparatus
to hold eight cases on stretchers. The plat-
form of the freight station where they were un-
loaded was level with the car doors so that re-
moval of the stretchers was an easy matter.
On the cement platfrom were three posts,
each one bearing the initial of the hospital
which it represented. When the train stopped
all the cases which were able to walk were
herded together in one place to wait their dis-
tribution. The cases on the stretchers were
brought out of the cars and placed in a long
row on the platform. Each one of the wounded
bore on one of his coat buttons the diagnosis
tag from the front which showed what his in-
jury was and what had so far been done for
him. Blake, who was the "Medecin Chef," ex-
amined the cases, beginning with one end of the
line, and decided to what hospital each one
was to be sent. He stated the name of the
89
THE DOCTOR'S PART
Hospital and an orderly who was with him fas-
tened to another button a tag which bore the
initial of that hospital. At once two French
orderlies took the litter and carried it to the
post bearing the same initial, and there the
ambulance orderlies collected the cases, put
them in the waiting ambulances and they were
carried to their destination. The cases which
could walk were dealt with in the same way
save that they went to the lettered posts under
their own steam. There were in attendance
women of the French Red Cross who gave the
men coffee, wine, oranges and cigarettes.
The distribution was systematic and rapid,
the process beginning as soon as the wounded
were unloaded from the train, and some of those
first taken off were on their way to clean sheets
and good care before the last of them had left
the train.
The entire process did not take more than
twenty minutes and seemed very business-like
and practical. It was, in reality, the "stock
00
HOSPITALS OF THE INTERIOR
yard" method and made for an accurate and
rapid sorting of the wounded.
On a man's arrival at the hospital he was
first cleaned up, and then, if not too fatigued,
taken to the X-ray room, where a careful ex-
amination of his injury was made and recorded
for the surgeon who would receive him as an
operative case. The majority of cases were not
photographed, in the actual sense of the word.
They were examined by the fluoroscope, which
enabled the man in charge of the X-ray work
to determine the nature of the lesion and to
furnish such data as would be required for
operation. Cases out of the ordinary run, or
those which showed pieces of shell remaining
in the tissues, were photographed and a chart
also made showing the exact location of the
foreign body. Surgery of the present time is
very dependent on the X-ray, and not only on
that but on various types of what are known
as "localizers."
There are several types of these : one a mag-
net, which when brought in proximity to a piece
91
THE DOCTOR'S PART
of steel is strong enough to cause a movement
of the fragment which is perceptible to the
fingers on the part. Others which have a tele-
phone adjustment for the ears of the operator
and a probe which on contact with the shell
fragment or bullet gives a distinct clicking
sound, the loudness or faintness of the click in-
dicating to the surgeon whether he is "hot or
cold" as we used to say in the childhood game.
From the X-ray room the wounded man goes
to the ward for rest unless his case is urgent,
in which event he is transferred direct to the
operating theater and the necessary work done
for him at once.
One is apt to think of a hospital as a neces-
sarily depressing place, the abode of suffering
and the place of not infrequent death. That
is true as far as the suffering goes, not so
now, fortunately, as to the frequent death, al-
though with war wounds there is no escape from
a certain percentage of fatalities. The one
thing which cannot be killed is the innate cheer-
fulness and good humor of the French soldier.
92
HOSPITALS OF THE INTERIOR
He may be drawn and white from the pain of
a dressing or the ache of the operation, but
give him time to compose the quivering nerves
and his gayety comes to the surface again and
he is ready to poke fun at himself or any one
else — and any one is fair game. There was
one youngster in the ''Machine Shop," which I
have alluded to, who interested me, and I used
to stop and talk to him every day in my rounds
of the ward. He was laid up with a shell frac-
ture of his left leg and right arm and was swung
in a maze of pulley ropes and weights. Despite
his incumbrances he was always cheery and
managed to do for himself very handily. We
used to chat each morning; I in my best French
and he in the rapid talk of the Poilu with more
or less slang intermixed. After I had known
him for about a week, he turned to me one day
and archly asked me, ''Say, Major, what's
the matter with us talkin' United States ?^^ We
did after that, and I found that the young
scoundrel had been bom in New York of French
parents, lived there all his nineteen years and
9S
THE DOCTOR'S PART
had come to France because he felt the call
of the Fatherland. He had been amusing him-
self in a good-humored way with my imperfect
French, and I suppose had been chuckling over
the fact that he was as much an American as
I. I daresay it amused his comrades, too. It
did not at all interrupt our amicable relations
and the only difference it made was that there-
after I deprived him of the satisfaction of lis-
tening to my attempts in his own French
tongue.
There was, for the other side of the picture,
one death in that ward which seemed sadly
pathetic to me. He was a strong peasant,
about forty years of age and so badly injured
that at his age he had not the vitality to fight
it through. I watched him go along the road
that leads over the big divide, each morning
finding him a little weaker in spite of his evi-
dent desire to win back to a maimed existence.
One morning I came into the ward to find his
people there and to be told by the ward sur-
geon that he had only a little time to last. The
94
HOSPITALS OF THE INTERIOR
Doctor had no French and asked me to do
what I could to comfort the poor souls who
had been summoned there bj the news that
their son and husband was to give the great
gift for his country.
I did the best I could, and I trust that what
I said to them helped a little. They were pa-
thetic peasant folk in awkward black, with
lined brown faces and hands hardened by much
toil. They were dignified in their grief and
made no outcry; just the dumb look of suffer-
ing in their faces as the breath halted and the
laboring chest rose and fell and finally became
still. One could know what it meant to them;
the loss of a good son, a well-loved husband.
And yet when it was all over and the poor tor-
tured soul had gone to the God who created it,
they turned to me and, with fine courtes}'',
thanked me for my words of sympathy, and as
they turned to leave the ward the old father
turned to me with his patient face, and straight-
ening his bent shoulders, looked at me with the
tears in his eyes and simply said, *'Eh bien,
95
THE DOCTOR'S PART
Monsieur le Majeur, c'est pour la France." In
spite of grief and the sense of los5 they could
yet realize that the life they had loved was
given for a cause that was sacred in their eyes
— for their country.
A hospital in a small town rather dominates
the life of the village : everything centers about
it and in the absence of the industry of peace
times it is an important factor in an economic
sense. In the village where this hospital was
situated, as in all the others in France, man
power was at a minimum, and among the rest
the village doctor and the pharmacist had gone
to war. As a consequence the good people were
dependent on the personnel of the hospital for
their care in sickness and for the remedies
which they required. This care is everywhere
freely given and in similar conditions it is as
much the duty of the Medical force of the hos-
pital to look out for the civilians as to care
for the wounded. It is fortunate that it is so,
for with no other help available there would
be much hardship among those who had only
96
HOSPITALS OF THE INTERIOR
to watch and wait for the return of the men
at the front.
In view of this, there grows up a close re-
lationship between the inhabitants and those
who care for the wounded. During my three
weeks in this little town I had a room in a quaint
little French inn and in a very short time I was
on friendly terms not only with the old man
and his wife who presided over it, but had a
speaking acquaintance with most of the people
of the village. They quickly learned what my
uniform was and, although at that time I was
a neutral — apparently — I met with nothing
save a fine and simple courtesy.
The French peasant class are as a rule a cour-
teous people and transactions with them carry
much more ceremony than that with which we
endow our daily comings and goings in these
busy United States. For example, the purchase
of my daily paper from the old lady who kept
the stationer shop was formal to this extent. I
entered the shop, tipped my cap and said,
"Good morning, Madame, it is a fine day."
97
THE DOCTOR'S PART
"Good morning, Monsieur le Majeur; it is in-
deed." "The Matin, if you please, Madame."
"But certainly, Monsieur, and thank you."
Then I gave her a fifty centime piece and she
said "Thank you. Monsieur." When she gave
me the change I said "Thank you, Madame,"
and I bowed myself out with a duet of "Bon
jour, Madame," and "Bon jour, Monsieur le
Majeur." I suppose that we have not time for
all that in our own busy materialistic Republic,
but it lends a touch of friendliness to the minor
things of life and is pleasant when you know it.
Probably one of the best known and certainly
one of the oldest hospitals in Paris given over
to Military use is the Val de Grace. There is
some very fine surgery of the face done there
by Dr. Moreston and the progress of the cases
is illustrated not only by photographs at dif-
ferent stages, but there is in the museum a
collection of masks made in wax and colored,
which though grewsome in themselves are very
beautifully done and illustrate very strikingly
what can be accomplished in this difficult
98
HOSPITALS OF THE INTERIOR
branch of surgery. In addition to caring for
sick and wounded this hospital has other func-
tions. The young men who have finished the
course at the school at Lyons in preparation
for entry into the regular Medical Corps of the
Army are sent there for a final course before
being sent out to active service, and, further-
more, the army nurses are also trained in the
same institution. Here, also, is situated the
Laboratory where the serum used to protect
against Typhoid and the two analogous fevers,
the para-typhoids, is prepared.
This is a very modem and up-to-date plant,
and if we consider that all the men of the French
army have been immunized with serum manu-
factured here it is easy to comprehend the mag-
nitude of the work. At the time I visited the
laboratory, in company with Vincent, who is
the head of it, he told me that they were not
only turning out all that was required for their
own forces, but were supplying Belgium, Rus-
sia, and sending some to Italy. The serum has
proved its efficiency, for since the early days of
99
THE DOCTOR'S PART
the war, before all the army had been inocu-
lated, typhoid has continued to be a negligible
cause of illness. That it is potent I have cause
to know from personal experience, for in spite
of the fact that I had gone through typhoid
as a young man and that I was beyond the
required age, I took the inoculation — and
cussed both Vincent and his serum, for in
addition to its protective power it has a
very unholy "kick." If any suffering citizen
is protected against enteric fever I surely
should be.
There is, near Paris, in the suburb of Issy-les-
Molineaux, a hospital which is interesting both
on account of the character of the injuries
treated in it and from the results obtained by
the treatment. It is the "Hospital San Nico-
las" and in it a service has been turned over to
Dr. Barthe-de-Sandfort for the treatment of
men who have been burned.
There are a number of these cases arising in
the Military service, and contrary to expecta-
tions, the majority of them arc from other
100
HOSPITALS OF THE INTERIOR
causes than the German **Liquid Fire." The
cases treated from this cause are rather infre-
quent. Why this is so I do not definitely know,
unless it be that those who are burned in this
manner generally succumb. It may be men-
tioned in passing that the Allies do not view
this form of warfare very seriously; they take
it as a manifestation of German frightfulness
and state that it has little real tactical advan-
tage.
There were about two hundred beds occupied
by the burned cases at the time that I visite(|
the hospital at Issy and together with them were
a number of cases of "Trench Foot" which were
stated to do well under the treatment. Trench
Foot is much like frostbite and the resultant
injury much resembles it. I saw during my
visit there burns of all degrees of severity, and
was impressed by the apparent comfort of the
method for the patients and the excellent results
obtained. The remedy itself is proprietary;
that is to say, Barthe-de-Sandfort refuses to
disclose the formula, holding it for financial
101
THE DOCTOR'S PART
gain. Under the ethics of the European coun-
tries this is viewed under a different light than
with us.
The treatment consists in the application, to
the dried surface of the burned area, of a liquid
preparation which contains paraffine and some
other undetermined ingredients. This seals up
the burned area and healing goes on under it
with great comfort to the patient and with a
most excellent final result. There is less scar
resulting and consequently less deformity.
Some of the completed cases were remarkable
when compared with their condition on entry
in the hospital.
Whatever be the ethics in regard to the treat-
ment, it seems to me that there is little doubt
that it is an effective method of dealing with a
distressing form of injury.
I quote this method mainly as an evidence of
what the changed conditions of modern warfare
have demanded in advance in Medical and Sur-
gical procedure. The increased skill in inflict-
ing bodily injury has evoked a measure of in-
102
HOSPITALS OF THE INTERIOR
genuity in the science of repair, and this is
manifested not only in this matter of the treat-
ment of burns, but in the many other special
methods and devices for the better repair of
the wounds of war.
CHAPTER IV
THE ZONE OF THE ARMIES
As I have mentioned before, continental
France is divided by an arbitrary line into two
general divisions — the Zone of the Interior and
the Zone of the Armies. In this latter Zone
are the majority of the Military Hospitals, not
all of which are subject to gunfire since this
zone extends from the first lines back to the
ultimate edge where the two zones join. This
Zone of the Armies is further subdivided into
three regions : the Zone of the Advance, which,
as its name implies, is that of the actual fight-
ing, the place of the combat: the Zone of the
Rear where reserves of personnel and materiel
are maintained for the reinforcement of those
at the front, and the Zone of the Line of Com-
munication, which is the traffic route by which
104
THE ZONE OF THE ARMIES
these reserves are brought forward and by
which the wastage is sent back for repair.
The character of the Medical service, of the
Hospitals, depends on which one of the three
different subdivisions they happen to be located
in, the more formal as a matter of course being
more removed from the actual fighting. Some
of the hospitals of the latter type are of par-
ticular interest and have occupied a more or
less prominent place in the public press and
have come to be pretty well known in this man-
ner to the average reader of the news. One of
these is Carrel's Hospital at Compiegne.
Most of us know of Carrel : of his association
with the Rockefeller Foundation ; that he won
the Nobel prize, and that recently he has estab-
lished in New York a hospital for the demon-
stration of his method of the treatment of in-
fected wounds. It would not, I presume, be
good taste for me to discuss the pros and cons
of his methods and as a matter of fact that is
hardly a function of any writing as non-tech-
nical as these pages.
106
THE DOCTOR'S PART
It was my good fortune to spend some time
with him in the winter of 1916 and I found my
visit both pleasant and profitable. In speaking
of it I quote from a running diary which I kept
during my tour in France, as events recorded
therein are more sharp than if I trust to a
recollection blurred somewhat by the passage of
two years' time and many other events which
have occurred since that visit.
"The 21 and %% of February I devoted
to a vigilant and persistent pursuit of a 'Camet
des Etrangers' in order that I might have the
right to come here to Compiegne.
'*I finally succeeded in running it down in
some Nth Bureau of the French War Office on
the Boulevard Saint Germain. A 'Garnet des
Etrangers' is your Passport into the Zone of
the Armies. It is a little red book, in the front
of which is pasted the worst possible postage
stamp picture of yourself and under it inscribed
a kennel register of yourself which takes you
back as many generations as you can remember.
The rest of the book is devoted, with French
106
THE ZONE OF THE ARMIES
thoroughness, to information on every subject
except how to beat an egg in hot weather and
contains forms appropriate to every occasion
except, perhaps, a christening. Without it you
cannot go anywhere, except to bed, and you
must do that within the limits of the Zone of the
Interior.
"When the proper form is duly filled out,
stamped and sealed by the *Grand Quartier
General' you can go — exactly where it says you
can : if you go anywhere else you are 'off side'
and liable to be set back and severely penalized.
Also you must show it to everybody on demand,
save the Fire Department, and I am not quite
sure about them. I had to show mine four
times between Paris and Compiegne and each
official looked more suspicious than the last
until I finally began to doubt my own integrity
and became as red as the book each time I pro-
duced it. You see I was in citizen's clothes, as
a representative of a neutral Government, and
it is hard for any Frenchman to understand
why any person described as a man of Military
107
THE DOCTOR^S PART
rank should be concealed in a brown sack suit.
"I left Paris at 8 :05 from the Gare du Nord.
The morning was cold and dreary and the out-
look from the train soggy and disconsolate.
The Oise was bank full and overflowing and
every one looked bedraggled and down at the
heels. Even the red pantaloons of the old ter-
ritorial soldiers who guarded the right of way
looked less cheerful than they should. At
Creil, which was at that time the dividing line
between the two general Zones, a very thorough
canvass was made of all passengers on the train
to make sure that no unauthorized person was
irrupting into forbidden territory.
"I arrived at Compiegne at about 11 and
came up to the hotel followed by a hoary old
Frenchman who puffed along with my luggage
and had such a luxuriant growth of whiskers
that all he needed was three decoys and a cup
of water to make him look like a duck blind.
Compiegne has been shelled by German 280 and
320 mm. guns from time to time and there are
ruined houses to bear testimony to the fact.
108
THE ZONE OF THE ARMIES
**Established at the Hotel Palace, I went to
take my letter of introduction to Carrel at his
hospital at *Rond Royal.' This was in the
piping times of peace a hotel, but like many
structures of that kind it has changed its sphere
of usefulness as the normal life of the state
has been turned upside down. The hospital is
not a large one, having a capacity of something
like a hundred beds, and Carrel does not claim
for it any great value as a large factor in the
care of the wounded. It is in reality his labora-
tory, where with the wounded for his material
he is working out the best method, in accordance
with his views and experience, of putting them
Tjdck again in the minimum of time, healed and
fit for more of war's alarms. The place is par-
tially supported by an appropriation from the
Rockefeller Institute, so that things are on a
more easy scale than if it were dependent alto-
gether on the resources of sadly tried France.
"There was plenty of everything: beds,
nurses, linen and all the essentials which make
for the comfort and well being of the wounded.
109
THE DOCTOR'S PART
I could not but feel that the soldier who was
brought here to be cured of his hurts was par-
ticularly favored.
"Carrel himself does no operative work. He
is the general administrator of the institution
and has a supervising eye on the cases and the
progress of the method which he is advocating
in the disinfection of wounds. Briefly, and not
too technically, the 'Carrel-Dakin' method of
treatment — sterilization, he calls it — of wounds
consists in the use of a solution of hypochlorite
of soda. It is a use of what is analogous to
the familiar 'Javelle Water' which we use to
take spots from our clothes and stains from
our hands. But in the use of this, according
to his method, there is no haphazard employ-
ment of the chemical : he has determined exactly
and precisely the percentage of the ingredients
which gives the best result and any departure
from the established proportion will not pro-
duce the end aimed at.
"The primary step in the process consists in
what the French term, 'debridement'. That
110
THE ZONE OF THE ARMIES
word, if you look it up in the French dictionary
will be given as 'taking the bridle off a horse'.
It refers, as the French surgeons employ it, to
an extensive wound of operation. They open
everything up wide, clean out all foreign bodies
and torn tissue and clots of blood and leave no
hidden corners for the malicious germs to linger
in. It is rather startling at first sight, but if
one has any Jesuitical tendencies he cannot but
believe after seeing the results, that 'the end
justifies the means.' Once opened up and
cleaned out, the wound is kept open by gauze
packing and subjected to a constant bath of
the Carrel Solution. This is fed into the wound
by rubber tubes which search out and go into
all the ultimate nooks and crannies in order that
there may be no area which is not constantly
bathed by the hypochlorite. Dressings are at
first made every day and as the wound becomes
progressively more free from infection, at longer
intervals. Cultures from the wounds are taken
every day at the dressing time and these as well
as the temperature and the clinical symptoms
111
THE DOCTOR'S PART
are the index of progress. When the culture
is negative, that is to say, when no bacteria are
found on microscopic examination of the slide,
the drainage is removed and the gaping wound
brought together by strips of adhesive tape,
and it promptly heals, leaving only a thin red
line to mark the injury. Of course in joint
injuries and extensive loss of bone there is more
marked evidence than this, but in all the cases
I saw during my visit healing was prompt and
sure. The question of the adaptability of this
method for all wounds is not one to be discussed
here.
"Eight in the morning is the dressing hour
and each day I am there to watch the work and
observe the progress of the healing. The dress-
ings are most carefully done; not entrusted to
the nurses, but done by the surgeons themselves
with due and strict regard to modern surgical
requirements. It is interesting from a profes-
sional standpoint, albeit a little sad, this patient
dressing of the pathetically patient wounded.
There is one for whom I feel a particular sym-
112
THE ZONE OF THE ARMIES
pathy. Robert Deviennes, he is, of the 417th
Infantry. He may be nineteen, not more: a
well built, good looking slip of a French lad
with dark hair and eyes, a straight little nose
and a facile mouth which I think must have been
merry until pain and constant suffering pulled
the corners down into a piteous droop. On his
left leg and thigh he has four wounds varying
in length from four to six inches; on the right
leg, the ends of all his toes are shot away and
on the same thigh, underneath, is a wound about
fourteen inches long, open and showing the
muscles and fascia. If you want to know what
such a wound looks like, go buy a beefsteak big
enough for a family of four and lay it on the
back of your thigh and then try and realize that
it is a tender, quivering area. He has two other
wounds that I cannot describe.
''Each morning the surgeons pull gauze out
of and push gauze into all those eight wounds
and sponge them and dress them. And Robert
Deviennes, of the 417th Infantry, grips the
sides of his white iron bed and the dark eyes
113
TH5- DOCTOR'S PART
close and the drooping corners of his mouth
come up to a straight, set line and the olive
color of his face goes a little gray while drops
of sweat stand out Hke tears from a tortured
system. But Robert Deviennes, of the 417th
Infantry, does not whimper, for he is not a child,
but a soldier of France, and he knows with the
knowledge of his nineteen years how to bear his
cross like a soldier. And these clever French
surgeons who poke and prod his quivering flesh
are making him whole again and before long he
will take his knapsack and his rifle and carry
his scars back to the trenches to chance other
shell bursts which may send him back to the
hospital at Rond Royal, or close the brave
black eyes and write 'finis' across the book of
his young life. I wish I might be sure that I
could bear so uncomplainingly the ills that
cannot make him cry.
"They — the wounded — are a singularly un-
complaining lot ; it is the exception for the pain
of dressing to elicit even a moan. The hands
grip tight shut and their faces twist in silent
114
THE ZONE OF THE ARMIES
protest, but they keep their breath to breathe
with and I have never seen one flinch or move
the wounded member, no matter how keen the
pain. I think that on the average, they are
better about it than our men. Why, I do not
know, for I am sure they have no more courage.
"There is a pathetic dignity about the
wounded that is hard to describe. Per se, the
mutilations are grotesque, but one seems to
see through them and beyond, to the love of
country that has made them run these risks,
and that, I think, helps sustain them through
the tiresome painful days while patient nature
fills up again the gaping holes and seals them
with the flaming scar tissue which is the Red
Badge of Courage of these, the 'Blesses.' And
so the man I saw this morning with one leg
gone just below the knee and the other just be-
low the hip did not suggest merely the crippled
remnant of vigorous manhood, but the exponent
of fearless self sacrifice — of duty done at the
expense of self and regardless of life or suf-
fering.
116
THE DOCTOR'S PART
"This afternoon I put on a suit of olive drab
uniform and went over to a General hospital
about a mile and a half outside of Compiegnc.
As a plain citizen, and so dressed I am toler-
ated, but to use a colloquial expression, I do
not 'cut much ice'. To be anybody nowadays
in embattled France you must have better cre-
dentials than a brown sack suit and an alpaca
umbrella. I found that I was taken much more
seriously in service dress than as an unassuming
citizen of the Great Republic.
"I was presented to the 'Medecin Chef and
he showed me about the institution and answered
my questions when he could understand them.
It was 'horse and horse' anyhow, for sometimes
when he understood the questions, I did not
understand the answers. He was cheerfully
polite and assured me that my French was quite
creditable, but I have a sneaking idea that he
had his fingers crossed and was making mental
reservations all the time he was complimenting
me. The hospital had formerly been a military
barracks and was a big affair of scattered brick
116
THE ZONE OF THE ARMIES
buildings which were being adapted to hospital
use. The process of transformation had just
been started and there was much to be done
and my French doctor shrugged his shoulders
and deplored that I could not have made my
visit a little later when he had been able to
evolve some sort of order out of the general
chaos which was an unavoidable accompaniment
of the change. He said that there was an in-
sufficiency of many things, which is not to be
wondered at when one considers the burden that
the State has had to assume in the care of those
who have been hurt in battle. It is the invari-
able and inevitable rule apparently that no gov-
ernment can be up to par in the treatment of
the wounded. It seems that no matter what
provisions are made they always fall more or
less short of meeting the conditions with abso-
lute satisfaction. The existence of the Red
Cross is evidence of that fact: given perfect
management, their function would be nil.
"There were about 1,400 sick and wounded in
the hospital that day and I was told that the
117
THE DOCTOR'S PART
ultimate capacity would be nearly double that
when everything was in order. The death rate
at that time was 2% for the Surgical cases and
5% for the Medical.
"It rained all the time I was there and the
impression of the rows of brick barracks was
rather cheerless and I came away with the con-
viction that I should rather win back to health
in the ward at Rond Royal than in this huge
home of the wounded.
"I came back in a big Military motor driven
at the usual rapid rate by a whiskered 'Poilu',
who told me among other things, that he was
convalescing from a wound and soon expected
to go back to his regiment and the front. He
seemed cheerfully indifferent about it and
thanked me politely for the pour boire which I
gave him * for the wounded'. I am inclined to
think that he put an entirely personal construc-
tion on that phrase in consideration of his own
hurt, and I have also a sneaking suspicion that
although Major Church in Service Uniform
rode home in a military machine, Major Church
118
THE ZONE OF THE ARMIES
in civilian clothes could have walked in the mud
and be damned to him.
"Madame Carrel has donated the band in-
struments to a regiment raised here and this
morning we went down to the Place to see the
regiment march away to the front and the
trenches, and many of them, I suppose to face
their Maker in another world. The music was
spirited and the men looked clean and rested
and very workmanlike in their horizon blue with
full kit and rifles with the wicked long French
bayonet across their shoulders.
"The shuffling throb of their feet on the old
French cobblestones beat out an accompani-
ment to the blare of the band and after it had
passed, with the head of the column, beyond
hearing, the beat of the marching tread sounded
like the pulse of the heart of France; steady,
strong and determined. There were about two
thousand of them and they made a long line as
they filed in column of fours through the old
square and past Joan of Arc who stood with
119
THE DOCTOR'S PART
her bronze hand raised to salute these soldier
sons of hers.
"There is something about the whispering
rhythm of a body of marching men that always
makes my heart beat a little faster. It may
be the association, but there is a swing and a
time to it that is almost music in itself. The
stamp of heavy shoes on earth or stone marks
the bass of 4/4 time: the brush of sleeves
against the sides, the creak of leather gear, the
mutter of low talk and soft laughter are the
air in treble, and the tinkle of metal on metal,
of bayonet and cup, make the arpeggios, the
running grace notes of this unwritten tune of
the fighting men. After they had all passed
and were only a soft echo in the distance. Doc-
tor and Madame Carrel and Paul UfFolz, who,
in spite of the strange name, wears the French
blue and is 'Medecin Principal Premiere Classe'
and Surgeon of the — Corps which is sta-
tioned here, came up to the Hotel and had
luncheon as my guests. It is interesting to
Itnow intimately a man so eminent in his pro-
120
THE ZONE OF THE ARMIES
fession as Carrel. He is short, full figured,
well set up and fair. He is quite bald and has
keen blue eyes which behind their heavy lenses
are gravely thoughtful or mirrors of mirth as
the discourse changes from sober topics to
lighter vein. He is clean shaven and has an at-
tractive mouth which expresses his mood equally
with his eyes. It is a strong face and an
attractive one.
"We talked of many things ; — not the 'ships
and shoes and sealing wax and cabbages and
kings' of Alice in Wonderland, but of Medicine
and the wounded; of Military procedure as it
affects our profession; of French politics and
American necessities, and of 'T. R.' whom they
all admired. They talked in slow French which
I understood, and in rapid French which I did
not, and Dr. and Madame Carrel to me in de-
lightful English with a charming French accent.
It was altogether delightfully informal and
human and I felt not at all like a 'looker on in
Venice' but as though I had been quite admitted
to the circle.
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THE DOCTOR'S PART
"All day yesterday the sky was gray. The
wind swept in gusts from the North and whirled
the snow in glittering 'dust devils' across the
bare expanse of the Place which stretches from
my window over to the great Chateau de Com-
piegne which faced me grim and inscrutable in
the bleak winter twilight of northern France.
The Chateau is now a Military Hospital for
medical cases. The tri-color hangs over the
gate and French soldiers are on guard in the
courtyard, and sick in the interior. And so
the summer palace of the kings and emperors
has come under the rule of the present master
of France, — War, with all its stern necessities
to satisfy. I wonder if the shade of the Em-
press Marie Louise flits through the salons
which once were hers, but now are wards for
the descendants of the soldiers who helped to
place in power her liege lord, the great Napo-
leon? If it is cold here in Compiegne, I wonder
what it is out in front twelve kilometers away
where 'shelter' means protection against sudden
death and not from cold: where light comes at
122
THE ZONE OF THE ARMIES
night from star rockets and the angry red of
shell bursts: where men stand in frozen mud,
sleep in caves and I am sure cannot be ever
warm. At twelve I was wakened by the roar
of iron tires on the cobbles of the square in
front of my window. I got up and looked out,
but Compiegne is dark at night with the black-
ness that seeks immunity from hostile air at-
tack and I could only listen and guess. I know
it was transportation, and I think there was
artillery and it was all going to the front. It
was nearly an hour in passing and as wagons
make about two miles the hour that would
mean a good sized convoy. At six this morn-
ing I was waked again by drums and trumpets
and got up to watch with sleepy eyes another
regiment file out up the fascinating little street
which is the way to *the front' and which is at
present barred to me. About eleven another
convoy, made up almost entirely of Sanitary
wagons, stamped with the Red Cross, rumbled
out and all afternoon stray wagons and auto-
mobiles have been dodging into the little street,
123
THE DOCTOR'S PART
bound, — goodness knows where. And my
'Garnet des Etrangers' sends me home to Paris
again to-morrow. Whether this is a normal
movement or an extension of the action raging
at Verdun I do not know."
Another Hospital equally well known with
Carrel's is that which is administered by
De Page, at La Panne which is in the little
remnant which remains of Belgium on the North
Sea. De Page's Hospital is a larger plant than
the one at Compiegne and is universally ad-
mitted to be one of the best on the front. It
is situated within easy gun fire of the German
lines but up to date has not suffered very
severely, although both shells and aeroplane
bombs have fallen on it. I had the pleasure of
visiting it in 1916 and came away impressed,
as I am sure all do who visit it, with the good
class of work done there and the completeness
of the institution. There have been numerous
descriptions of this hospital published and I am
afraid that if I undertook the same task I
should duplicate what has already been well
124
THE ZONE OF THE ARMIES
done. La Panne in itself is merely a large
amount of sea sand, spread in a beautiful broad
beach along the ocean front and back from that
piled in irregular dunes and sifted in a fine
powder through the streets of the village to clog
the footsteps of the pedestrian. The Hospital
has as its nucleus the Hotel Ocean, a typical
summer hotel, and about it are clustered the
wards and other buildings which go to make
up the total of this institution. Due to the
contour of the ground, it has not been feasible
to build a number of small wards, and so there
are several of 100 bed capacity. These seem
unduly large to one accustomed to the normal
capacity of thirty or forty, but there seemed
to be no difficulty in the administration, and the
wounded get well in them, which is after all the
principal and desired function of any unit of
this kind.
As an evidence of the completeness of the
plant I may state that De Page maintains
in the hospital, as a part of it, a very complete
machine shop presided over by competent
125
THE DOCTOR'S PART
mechanics, and that they not only repair sur-
gical instruments and appliances which are used
up or damaged in service, but they also make
new ones and exceedingly good ones too. This
is all done from the raw material and is a great
help inasmuch as it obviates the necessity for
ordering from an outside source and the delay
and uncertainty of delivery under wartime con-
ditions. The same orderly routine is in evi-
dence at La Panne as in any of the well ar-
ranged and well managed hospitals on the
Western front. The wounded come in to a
receiving ward and follow a definite channel in
accordance with their needs. It is what I have
already referred to as the "packing house sys-
tem" and is based on the division of labor ; each
place is charged with certain duties and on
completion of them sends the patient on to the
next section.
De Page ranks probably as the foremost sur-
geon in Belgium and has associated with him a
corps of skillful colleagues and assistants and a
competent nursing force. At the time I was
126
THE ZONE OF THE ARMIES
there a certain proportion of this personnel,
both Medical and nursing, was made up of
Americans, under the auspices of the Red Cross,
and in this way a leaven of our own people was
being instructed in the ways of the new surgery
of the wai thus to serve as a factor in spreading
this knowledge through the body of those who
are now to go and take their own places with
our own fighting force.
On a Sunday afternoon while I was there a
conference of the Medical Officers of the Hos-
pital and of the surrounding district was held
in one of the large buildings adapted to the
purpose. There were about two hundred and
fifty present; Belgian and French, and I felt
in a decided minority as the only representative
of the United States Army.
The lecture was by an eminent Professor,
from Ghent I think, and his subject was "Evo-
lution" but truth to tell I was more interested
in watching Queen Elizabeth of Belgium, who
sat about four feet from me, than in the fact
that I might have been developed from some sort
1^7
THE DOCTOR'S PART
of a prior form of protoplasmic life. She is
small, sad faced, rather good looking and dig-
nified, as I suppose all Queens are. She re^
minded me a little of Maude Adams. Alas, I
did not have an opportunity to meet her and
I suppose I shall never be so near another
Queen. She has been much interested in this
hospital and has herself nursed there. In addi-
tion to the Hospital at La Panne there is a
large bath establishment and Laundry which
works for the Belgian Army. The bath house
provides 1,500 tub and shower baths daily and
any one who has ever been in the trenches will
know what a factor to comfort and well being
this is to the dirty wretch who comes back to
the rest camp thoroughly dirty and also, alas,
generally thoroughly inhabited.
The laundry works for 75,000 men and
washes 16,000 pieces daily. When you con-
sider that in addition to the washing, a large
proportion of the clothing has to be disinfected,
— de-loused — to put it plainly, this is no mean
task.
128
THE ZONE OF THE ARMIES
This keeping an army clean is a problem in
itself and many solutions have been tried, none
of which combines all good features and no bad.
The large establishment cannot of necessity be
placed very close to the lines for fear of demoli-
tion by hostile gun-fire. Smaller units of the
kind are a proportionately greater expense
than where there is chance for systematic divi-
sion of labor, as there is in the larger type.
Hand work is slow and uncertain and of course
transport to laundries situated in the back
areas involves the same old question of trans-
portation. One thing has come to be estab-
lished in regard to this work and that is that
there shall be a community of underclothes and
in a measure of outer garments too. They do
not undertake to deliver to the individual the
things he takes off. These are started on a
journey through the machinery which shall
eventually leave them clean and mended if need
be, and the man who has cast them from him
finds when he has emerged from his bath, others
of the same type which he substitutes for his
129
THE DOCTOR'S PART
own. Whether that will work out with our
men who are given to individual fancies in re-
gard to what they wear under their uniforms
remains to be determined. The system is prac-
tical in that it makes for little delay in provid-
ing the man with fresh clean linen, and as these
men are accustomed to a uniform type it does
not make much difference to the individual un-
less some luckless runt may happen to draw the
apparel of some one twice his size and girth.
In that event however there is chance of appeal
for a reduction or extension, as the case may
be.
I spent the night of my cpoing and of my
returning at Dunkerque, in the Hotel des
Arcades which is on the Place Jean Bart. The
hotel was at that time a mute evidence of the
pernicious activities of the Hun and most of
the windows and mirrors had given up their
shining lives to the fierce bursts of shells or
bombs. Fritz bombed us both nights I spent
in the queer little town but did little damage
on either occasion as the French planes and the
130
THE ZONE OF THE ARMIES
anti-aircraft guns drove him away before he
could accomplish much. Most of my visits to
outlying towns near the front were synchronized
with Hun air activity and eventually I felt
rather slighted if I were not awakened some
time during the night or the gray hours of the
morning by the combined racket of bombs and
gunfire. I had the doubtful pleasure of being
bombed three times in one night in one town and
distinctly resented what seemed like an entirely
gratuitous interference with my night's sleep,
for it is next to impossible either to go to sleep
or stay asleep with the racket of an air raid in
progress. There was one air raid which did
not result entirely in damage to the French.
In a certain town, not far removed from the
front lines and within easy bombing distance,
there had been several attacks directed at the
Post Office which, under the French system of
Governmental control, comprised the telegraph
as well as the service of the mails. They got
it, I think, on the third night's try : got it good
and plenty. I was in the town the next mom-
131
THE DOCTOR'S PART
ing and the remains of that Post Office were
scattered all over the street and the entire
building was a disreputable pile of crumpled
masonry and twisted iron. The French Officer
with whom I looked over the ruin admitted that
Fritz had mussed up their Postal service for a
day or so, but told me with a cheerful grin that
they had had the foresight to install the said
Post Office in a building owned by G. H. Mumm
who was then looking through the wires from
the inside of an internment camp for enemy
aliens and that any material loss for property
destroyed would be a matter of regret to him
and not to any good son of France. I confess
that I did not feel the amount of sympathy for
Mr. Mumm that I might have if he had not
always insisted on so high a tariff for his
product.
There are a number of hospitals of the type
of these two located in the Zone of the Armies.
Many of them are within range of bombard-
ment, but none of them are located so that
they will be exposed to constant shell fire. It
132
THE ZONE OF THE ARMIES
is necessary to have them as close as is consist-
ent with reasonable safety, for I have stated
that it has been proved that a man's chances
in the present war are much better if he has
opportunity for prompt operation than if he
has to be transported for a considerable dis-
tance with the attendant delay. The French
have established, also, special hospitals for the
treatment of particular injuries and presided
over by men who are specially skillful in ihe
treatment of these conditions. In addition to
receiving and caring for the cases themselves,
these institutions serve as schools for selected
Medical Officers who go to them for instruction
and then return to their Corps or Division to
act as supplementary teachers to the personnel
therein. I saw a unit of this kind given over
to the care and treatment of fracture cases and,
in addition to the actual surgical work it was
turning out, men who by reason of the instruc-
tion received there were specially qualified to
carry on the work in other localities.
Still nearer to the front are units of another
133
THE DOCTOR'S PART
kind : the Ambulances of the First Line, and the
Evacuation Hospitals. In the first of these
one sees a different class of cases than those
encountered at a greater distance from the
fighting. Here the blood is fresh, and it is in
these that the desperate cases have their chance
to win back to some sort of life, or finish for-
ever the uncertain career of the fighting men.
In 1916, while the Crown Prince was still
butting his stupid head against the iron wall
at Verdun, it was my good fortune to inspect
some of the Sanitary formations in this hard
fought sector. At that time, as every one knows
now, the replenishment of the forces about Ver-
dun with men and supplies was carried on by
means of motor transport over the road from
Bar-le-Duc — the "sacred road" — as it was
termed. My pass took me to Bar-le-Duc and
there I had to have my papers countersigned
and send the motor for a supply of gasoline.
While waiting for its return I stood on the
corner in front of Headquarters and watched
the transportation lumber by. I was impressed
134
THE ZONE OF THE ARMIES
by the apparently never ending stream of
trucks which thundered along in double line,
one coming from the front and the other going
out. As a matter of satisfying my curiosity I
held my watch and timed the passing. As I
stood there counting, my French officer guide
came up and after waiting a moment said to
me, "And how many do you make them?"
"One every fifteen seconds each . way," I an-
swered. He told me that if that was the case
they were running on schedule and that if I
had stood at that corner for the previous three
months, watch in hand, I should have found the
same rate of travel, night and day. It is about
forty miles from Bar to Verdun and one can
see what that means with a double line of
trucks running at 15 seconds' headway night
and day. It seemed as though all the transpor-
tation in the world was rumbling up and down
that road. While waiting for the return of our
machine I witnessed an incident which im-
pressed me and gave me a clear idea of the
cheerful loyalty of France to her soldiers.
135
THE DOCTOR'S PART
Many of the returning trucks carried loads
of "poilus" coming back from the front for
their period of rest and recuperation. They
were stained and worn, covered from head to
foot with the white, flour-like dust which covers
everything where the wheels of the camions
grind the road to powder with their ceaseless
turning ; but withal they were a cheerful, merry
set and apparently not too tired for jest and
laughter. The line halted for a minute and a
woman leading a little, girl by the hand passed
in the rear of one of the soldier laden trucks.
They all hailed her in voluble French and she
and they tossed the ball of badinage back and
forth for a few brief minutes and then as the
procession started again, evidently in answer
to an appeal and to outstretched hands, the
woman reached in her basket and tossed up to
the dusty soldiers one of the big French loaves
which are such a staple of peasant sustenance.
They cheered her as they rolled away in their
aura of golden dust and she and the little girl,
both clad in black, went their way smilingly
136
THE ZONE OF THE ARMIES
and evidently with no regret that a goodly por-
tion of their supper had gone to the defenders
of their homes.
The ride from Bar-le-Duc on towards
Verdun was more or less of an educa-
tion. This constantly traveled highway was
broad and well kept — for heavy transport at
least — but the smooth surface had been ground
off by countless solid tires. We passed a num-
ber of busy steam rollers and all along the en-
tire route, within speaking distance of each
other, were men, the older men, patching and
repairing this artery of travel. They stood
with their shovels and rakes and at the least sign
of disintegration in the portion which they
guarded they threw in a shovelful of crushed
rock, hastily leveled it with their rakes and
the steadily tramping trucks beat it down for
the final repair. At every turn, or crossing, and
at the entrance and exit of each village, soldiers
with long clubs were stationed, the military
police of this busy road. Of course there were
signs ; signs with French thoroughness which
137
THE DOCTOR'S PART
told you exactly what you could or could not
do. On each side of the road, as far as the eye
could see, were stacks of supplies: supplies of
every description and every conceivable sort.
And all the ground out here was raw, and
trampled by foot and hoof — and a welter of
mud. From one hill I counted ten captive bal-
loons, "sausages" hanging against the gray sky.
We went first to D , a village where one
of the First Ambulances was located. Near
it were parked the automobiles of one of the
sections of the American Ambulance which was
busy evacuating the wounded from this always
busy sector. The hospital itself was located
partly in the Parish house of the church and
partly in tents in the yard. Cases were brought
to it direct from the trenches, less than two
hours away. The surgeon who was in com-
mand was a man well known in Paris and he
looked tired and strained as he showed us over
his establishment. He said that he had been at
work here for some months and that the duties
were exacting, which I could well believe. He
138
THE ZONE OF THE ARMIES
was there with one other surgeon as his assist-
ant and between them they managed about forty-
operations each day. With me was a member
of the American Relief Clearing House which
did such good work for the French and he asked
if there was anything that could be furnished
which would make work easier and add to their
resources. Indeed there was. Although they
were as well supplied as possible, there were a
number of things which would add much to the
efficiency and he named some of them — a larger
sterilizer for dressings, certain instruments, and
as he found that his needs did not appal my
friend he added to his list, growing more cheer-
ful each minute at the thought of this unex-
pected help. I may as well state here that all
the things he craved so wistfully for the better-
ment of his wounded were shipped to him with
commendable promptness and I have no doubt
that he profited by them. With a more cheer-
ful mien he showed us through his little hos-
pital. There were wounded everywhere : on the
operating tables for operation or dressings ; on
139
THE DOCTOR'S PART
litters on the floor waiting their turn and in
cots in the tent wards. .
Some of the wards were comparatively cheer-
ful; filled with those who would soon be well
enough to go and take their places in that
inferno so short a distance away. Two were not
so cheerful. One of them housed the gangrene
cases of which the less said the better. I knew
what it was before I went in and the peculiar,
distinctive odor is one that cannot be mistaken,
nor readily forgotten. The other was given
over to the hopeless ones who had no chance to
live; only the hard luck to fight out there the
brief interval of tortured hfe left to them.
There were two sheeted figures in a corner who
had not yet been carried away and in the little
time I was in the ward another died. As we
came out the doctor stopped by a bed where a
man half sat, half lay against the breast of a
tired orderly. His whole head was swathed in
red stained bandages and he beat stiffl}^ on the
covers with his hands and called something in
a muffled monotone which they told me was
140
THE ZONE OF THE ARMIES
meant for "water." Both his eyes and the most
of his face had been shot away that morning
and he could not swallow. The doctor ordered
morphine for him and I was glad to come away.
They told me that the shell wounds were very
bad and showed a tendency to develop rapid and
fatal gas gangrene, due presumably to the
ever present mud which infects all wounds. The
hospitals of this class count among the cases
they treat many that one does not see in those
farther back, since it is to these that the non-
transportable are brought for such operative
work as may be advisable or necessary. The
consequence is that they are much more harrow-
ing than those which treat men who have re-
covered from the first shock of their wounds and
presumably have a fair chance of being restored
in some semblance of their original selves. The
roar of the guns was constant here and some
shells dropped near, but none in our immediate
vicinity. They told me that a number had fallen
in the grounds occupied by the hospital, but
that so far there had been no casualties. The
141
THE DOCTOR'S PART
ambulance was situated some four or five kilo-
meters from Verdun and therefore in easy gun
range of the German fire. It was, all in all, a
sad and rather depressing place and aside from
the professional interest there was nothing save
an unjustifiable and morbid curiosity which was
a valid reason for a visit to it.
This type of ambulance is normally a mobile
unit and travels with the division to which it is
attached. In order to make provision for the
cases which cannot be moved, the non-transport-
able wounded, it is possible to immobilize such
of them as may be necessary and by the addi-
tion of a further section one can be turned from
a unit designed merely for the temporary care
of the wounded to a First Line Field Hospital
of the type of the one I have described. When
the necessity has passed the additional section
is detached and the normal unit takes on again
its mobile function.
Near the Ambulance at D there was
another first line unit which has come into
existence since the commencement of the present
142
THE ZONE OF THE ARMIES
war. It is known as the Automobile Surgical
Ambulance, and was designed with the object
of meeting the condition which I have several
times referred to, namely the prompt and thor-
ough operative care of the wounded. The Am-
bulances of this type are presided over by a
Surgeon of proved and special surgical skill
and the personnel is more generous than that
provided for the ordinary first line Ambulance.
They are designed for the care of serious cases
and none others are supposed to be sent to
them. They are self contained units and all
their material is packed on trucks so that they
are available for any section of the line where
the fighting is heavy and their need imperative.
They are ingenious in their compactness and
have proved useful in the solution of a difficult
problem. One of the trucks is fitted with ap-
paratus for the sterilization of instruments and
dressings and another runs an X-ray outfit,
either in the truck itself, or by the extension of
the wires, in a tent, or a building if there be one
which can be utilized. In addition to the X-ray
143
THE DOCTOR'S PART
current, sufficient power is generated to light
the operating room, so that work may go on
uninterruptedly night or day with good illumi-
nation. What an advantage this is, any of my
professional brothers who have stumbled
through intricate operative work to the flicker-
ing illumination of lamp or candle, can testify.
In addition to the paraphernalia necessary for
operations, there are several knock down bar-
racks which can be set up in little time and
used to house the wounded. In addition there
are tents which can be used to extend the capac-
ity and with these resources the unit can care
for a very appreciable number of wounded and
give them the benefit of prompt and thorough
surgical intervention. When possible, the
French set these units up where there is a house
of some sort and thus get the benefit of better
construction and housing than if they depend-
ed on the portable shelter, but they are de-
signed to be self supporting and to function
irrespective of any permanent habitation.
There was no available shelter for the one I
144>
Operating Room on a "Sanitary Train."
Interior of a French Dental Ambulance. This is a
Rolling Dental Office, Completely Fitted and
Mounted on an Automobile Truck.
THE ZONE OF THE ARMIES
saw near D and it was working in the bar-
racks and tents.
The operating room was painted white
on the inside, well lighted and there were
four or five tables presided over bj a
proper quota of personnel. Here, as at D ,
there was an abundance of wounded. All the
tables were occupied and there was a row of
bandaged figures on litters on the floor waiting
their turn and the verdict of the surgeon. The
wounds were all bad, for as I have said, it is
the serious cases which come to these well
equipped, compact little hospitals. The oper-
ative work was skillful and rapidly done and
so far as I could judge by the statistics given
me, the results were very creditable. I saw
several operations done, major operations, and
it struck me that this sort of unit had a very
real place in the scheme of modem care of the
wounded. The wounded were the same patient
lot that I found them everywhere I saw them.
They got on the table with no reluctance ap-
parently and those who waited their turn oa
147
THE DOCTOR'S PART
the litters made no complaint and did not seem
shocked at the atmosphere in which they waited.
I suppose that after living a life where each day
brings death in one dreadful form or another
before one's eyes, the air of an operating room
even with the distinctive attendant smell of
fresh blood and all that goes to make up that
complex whole, must seem in a measure restful.
It is certainly the antithesis of the front line.
There it is dirt and destruction and the only
chance is from bad to worse ; here, it is cleanli-
ness, reconstruction and the cunning work of
busy fingers to put into place again all that has
been torn asunder by the many engines of war.
In spite of the fact that this Ambulance was
devoted to the care of more serious cases than
the one at D , the entire atmosphere was
less depressing and I left it with less heaviness
of heart than the one in the Parish house pre-
sided over by the tired surgeon who craved
additional comforts for his wounded. There
were several Ambulances grouped at this point ;
the Automobile Ambulance and others of the
148
THE ZONE OF THE ARMIES
type of the one at D , making quite a little
center, or colony of the wounded. They were
all marked by the flag of the Geneva Conven-
tion, both as flags proper, and by the Red
Cross painted on the roofs of the buildings.
They had been established there for some
months and there was no possible doubt as to
what they were, — and yet that did not prevent
the ingenious Hun from very thoroughly bomb-
ing them with characteristic German persist-
ence not a great while after my visit there. The
results were about what might have been ex-
pected, and probably what the Boche did ex-
pect. There were a number of the wounded and
of the nurses killed and wounded again — and
that was the extent of the Military advantage.
I am not sorry to say that there were included
among the casualties a number of German pris-
oners who had been brought there to have their
hurts tended and healed by the French. Under
certain circumstances the bombing or bom-
bardment of Sanitary units may be an unavoid-
able incident of war. That is to say if thej
149
THE DOCTOR'S PART
are so located that they may be readily con-
fused with buildings given over to the use of
the combatant forces. Incidents of that kind
while of course deplorable are not subject for
condemnation, but must be taken as a part of
a business which at the best shows little mercy.
So many hospitals and sanitary units have
been attacked by the Germans, both at that time
and subsequently, that one is driven to the in-
evitable conclusion that it was a part of a well
conceived plan of frightfulness and in no way
attributable to the errors of judgment of those
who executed the work. It is this sort of thing
which has made Germany an Ishmael of the
Nations. This ruthless singleness of purpose ;
this intent to destroy anything which lives and
is not German. I went abroad, not neutral, but
with a fairly open mind in regard to the pos-
sible exaggeration of some of the reports of
German conduct. I found others over there who
had been of the same opinion at first. I found
none who had not changed to bitter condemna-
tion and it was only a short time before I was
150
THE ZONE OF THE ARMIES
forced to the same conclusion. Personally, I
saw no atrocities ; I was not in a position to see
them. I had however many friends among the
French, people of incontestable veracity and of
fairness of mind, and what they told me was
sufficient, aside from published accounts of such
acts as the bombing of Hospitals, to leave me
with the same shuddering opinion of the Ger-
man character as is held now by almost every
one who knows their works.
An important unit of the Zone of the Armies
is the Evacuation Hospital. These are usually
situated at Railhead and serve a double func-
tion ; one as a clearing house, and the other as
a Hospital for the care of cases whiv^h come to
it and are not fitted to be sent further. They
are an outgrowth of the war and occupy a
prominent place in the care of the sick and
wounded. Unless specially constructed, they
are located in buildings adapted for the purpose
and oftentimes much ingenuity is shown in
making use of the resources which were original-
ly intended for a very different purpose. Those
161
THE DOCTOR'S PART
which are at Railhead or attached to Railroad
stations are naturally, and fairly so, subject
to bombardment. An evacuation hospital is
provided for each Army Corps. Its bed capac-
ity and personnel is not fixed as its capacity is
planned for on the basis of the probable or
possible demands that will be made on it. It is
an organization belonging to the Zone of the
Advance, although until very recently it was
accredited to the Zone of the Line of Com-
munication. The central idea about which the
French Medical Service has been built is the
necessity for keeping every sick and wounded
man who can be returned to duty in a reason-
able time in the Zone of the Armies. This I
have previously referred to. The most im-
portant single element in carrying out this idea
is the Evacuation Hospital. In talking with
French Medical officers the word "triage"
(sorting) is constantly heard and one comes to
realize how important a part this classification
of wounded plays in the French scheme. While
this sorting process is begun in the most ad-
152
THE ZONE OF THE ARMIES
vanced Sanitary formations, it is at the Evacu-
ation Hospital that its full importance is seen.
That it is considered the vital factor in main-
taining the strength of the combatant organiza-
tions there can be no doubt.
As I have said above, the personnel and equip-
ment of these units is not specified. Formerly,
they were, as the name implies, collecting points
at Railhead for the evacuation of wounded and
sick. Experience in war has caused radical
changes in the organization of the unit. It
now consists of two sections, one for evacuation
and the other for hospitalization of patients.
The two sections are under one officer who ad-
ministers both. The personnel of the second
section depends on the size of the hospital and
the activity of the sector in which it is located.
In periods of calm, twenty Medical Officers, two
hundred enlisted men and about twenty women-
nurses will suffice. When the front becomes
active, forty or fifty Officers, three to four hun-
dred enlisted men and a proportionate increase
of women nurses will be required.
153
THE DOCTOR'S PART
Briefly, the function of the Evacuation Hos-
pital is:
1. To avoid the exodus toward the interior
of the large number of slightly wounded who
can be returned to duty in a short time.
2. To insure the rapid and comfortable
evacuation to the interior of wounded and sick
who will require long treatment and who would
uselessly encumber the Zone of the Armies.
3. To assure proper hospital care in the
Zone of the Armies of wounded and sick who
are non-transportable, or transportable for
only a short distance.
The location of an Evacuation Hospital must
be on a railroad. It must be as close to the
front as possible and connected by good roads
with the Field Hospitals. It must comprise
suitable covered entrance for the unloading of
patients from the ambulances; receiving rooms
where classification of patients is made ; shelter
in separate places for seated wounded, recum-
bent wounded and the sick who are waiting
evacuation ; hospital wards, operating rooms for
164
THE ZONE OF THE ARMIES
the non-transportable cases and a small isola-
tion section for contagious diseases waiting
transportation to a contagious disease hospital.
Formerly, existing buildings were adapted
for the purpose as I stated previously, but as
a matter of fact, at the present time these hos-
pitals are now all constructed for the purpose
they are to serve. It is absolutely essential that
a railroad shall be In the immediate vicinity, or
that a spur shall be run in, and that there be a
loading quai on the level of the floor of the
train. As to the capacity of the Hospital sec-
tion of this unit, no definite rule can be laid
down. It is inevitable that in periods of calm
the hospital will not be working to capacity, and
it is equally inevitable that in time of great
activity its capacity and personnel will be over-
taxed. On the average, they are designed to
accommodate, in the Evacuation Section, 1,000
sitting cases and 400 recumbent waiting trans-
fer by hospital train; the Hospital section,
from 400 to 600 patients.
The work of these hospitals differs materially
155
THE DOCTOR'S PART
in time of calm and in time of great activity.
In the first instance they care for all the serious
cases arising on the front to which they belong.
Many of them have well organized and equipped
departments for the care of the special cases,
such as plastic surgery of the face, eye, ear,
nose and throat and similar special conditions.
In periods of great activity their work is prac-
tically confined to the care of the non-transport-
able wounded, and the forwarding, through the
evacuation section, of those who are to go far-
ther back.
From the above it can readily be seen what
an important role in the Sanitary service these
hospitals play, and their adaptability to con-
ditions of relative inaction and of great stress.
I visited a number of these interesting units
located in different parts of France, from near
the North Sea to the vicinity of the Swiss fron-
tier. One that I saw in Northern France was
located in a railroad station and installed in
the buildings which were already there. They
had made use of the freight shed since it was a
156
THE ZONE OF THE ARMIES
large building and had the added advantage of
having a quai, or platform, which was on a level
with the car floors and thus made the loading of
the trains a relatively easy matter. This big
shed had been divided by temporary partitions
into different rooms to meet the needs of the
unit. There was no formal hospital in connec-
tion with it, the cases needing urgent care be-
ing transferred a short distance to one of the
hospitals in the immediate vicinity. This was
a wise precaution, for the station was very fre-
quently bombed by airplanes and the risk of
attending casualties among the helpless wound-
ed counterbalanced any advantage which might
have been gained by installing the hospital sec-
tion. It served as a station for "triage" and
the only wards were those in which the recum-
bent wounded waited the departure of the daily
train which was to transfer them farther to the
rear. There were holes in the roof and no glass
in the windows and the Surgeon in charge
showed me one bed which had been riddled, both
mattress and pillows, by fragments of a bomb
157
THE DOCTOR'S PART
\rliich had fallen on the unit a night or tiro pre-
Tiously. As one of the older type, this had no
special construction and much ingenuity had
been exercised in adapting the buildings of the
station for their present use.
At R , northeast of Verdun, I saw one
of the later construction. This was at some
little distance from the railroad station, but
joined up to it by spur tracks which allowed
the running in of trains for loading. The
Surgeon in charge told me that they were not
particularly busy at the time I visited it, but
remarked in a nonchalant way that they did not
consider that they had done a fair day's work
unless they had forwarded through the evacua-
tion section in the neighborhood of a thousand
sick and wounded. The hospital section here
was of about eight hundred bed capacity and
the turn over from it depended on the condi-
tion of the cases in it and also on the pressure
of work. Pressure of work is a factor in regard
to these hospitals for the reason that when there
is a drive imminent, or in progress, every case
158
THE ZONE OF THE ARMIES
that can be safely moved, is moved in order
that there may be bed space for the tide of
wounded which will flow in as the result of active
hostilities. The movement of the wounded
through an institution of this sort involves a
deal of detail. As they arrive they must be
unloaded from train or ambulance, they must
be sorted in accordance with their necessities,
check records must be made and certain data
entered on the personal records which each man
carries with him. They must be fed, each one
must be carefully examined to determine the
condition of his dressings and in many cases
these must be renewed before he is shipped fur-
ther down the line. Arrangements have to be
made for the makeup of the train that is to
carry them on and word sent to the different
receiving points in order that when they arrive
they shall find adequate preparation for their
reception. I was struck by the methodical way
in which all this ran: there seemed to be no
hitch, no lost motion, and yet no one seemed
to be in a hurry or even to have the appearance
159
THE DOCTOR'S PART
of being very busy. I apologized to my friend
the Chief Surgeon for taking his time to pilot
me about. He protested mildly, that he was not
very busy, that I in nowise interfered with the
routine and concluded by saying that things
were so regulated that he was quite sure that
all would go on perfectly well if he went to bed
and remained there until the next morning.
There were a number of German prisoners there
waiting to be sent on into the interior. The
majority of those I saw at this hospital at this
time were undersized boys, not very well nour-
ished and apparently very glad to be in a safe
place and through with war's alarms. They
were by no means representative of Germany's
man power however, for many months later I
saw many others who were as husky, able bodied
brutes as one would wish to encounter — or not
to encounter save under similar circumstances,
for the only Germans that ever looked good to
me were either prisoners or dead.
As I was walking down a path between two of
the wards the Surgeon stopped a minute to talk
160
THE ZONE OF THE ARMIES
to an orderly and I went on alone, passing a
group of French Sanitary Soldiers. They salut-
ed as I passed, looking with curiosity at my uni-
form and after I had gotten by, I heard in un-
mistakable United States, "Well, I'll be damned !
What in hell do you know about that ! I haven't
seen one in over two years and he certainly looks
good to me." I wheeled and went back to the
group and asked, in English, if the man who
had been talking would mind coming and hav-
ing a few words with me. Out stepped a short,
gray haired man of about fifty, the least Amer-
ican looking one of the lot and with a good
French salute and an embarrassed air said, "It
was me. Major, but I meant no disrespect, and
I was that astonished that maybe I spoke louder
than I intended. You see I haven't seen an
Aijierican Officer now since the war started and
I just couldn't help it." I assured him that I
had come back solely to have a few minutes'
chat with him and not to take exception to his
diction, and to prove it, wound up with, "And
where in hell did you come from.'^" He explained
161
THE DOCTOR'S PART
that he had spent almost all his life in New
York although he had been bom in France;
that he was a naturalized American but that he
could not stand the strain when war was de-
clared, so he had come over and enlisted with
the French. His one grievance seemed to be
that in view of his fifty years they would not
put him in as a combatant and so he had been
obliged to content himself with the duties of a
Brancardier, or litter bearer.
This he had been doing since the beginning
of the war, and knowing as I did, the kind of
work that not infrequently falls to the lot of the
litter bearers in their search for wounded, I
was not sure that his lot had always been in the
easy places he considered it had fallen. He was
sturdy, and strong, a French type, and blended
well with the group which surrounded him. He
presented some of his brother non-commissioned
officers, for he was a Sergeant, and we had a
cheerful chat and when my French was too tech-
nical for the others he set them straight and
when they wandered too far into the slang of the
162
THE ZONE OF THE ARMIES
trenches he translated that into equivalent
American slang for me and we laughed and
joked while my friend the Surgeon stood a little
apart with an amused smile on his face and
waited until I should have concluded the ameni-
ties with this wandering countryman of mine
who was the link between us both with his love
of one country and his allegiance to the other.
He was a good Sergeant, he said, faithful and
hard working and deserving of much credit. I
saw other Evacuation Hospitals in different
sectors of the line ; some of the improvised type
and some constructed for the purpose as this
one was. They all ran, however, on the same
general plan and the functioning was smooth,
regular and almost automatic. In the elabora-
tion of this step in the care of the wounded the
French have standardized, so to speak, the ad-
ministrative method so that there seems to be
little trouble with the functioning.
The units already referred to constitute those
which are of the most importance in the Zone
of the Armies, but it must not be inferred that
163
THE DOCTOR'S PART
the others which exist have no place in the Sani-
tary scheme. As they have been referred to in
the Chapter on the General Sanitary system of
the French, I make no further reference to them
here.
I had one personal experience with Military
Hospitals which left me with a very pleasant
impression and a distinct sense of gratitude. In
May 1917 it was necessary for me to make a
yisit to the British lines in connection with some
official duty. We left Paris in the early morn-
ing, by automobile, and although I was not feel-
ing well when I started I figured that a run in
the open car would put me on my feet. Soon
after starting I developed a persistent and
distressing cough which clung to me for the 150
miles that we covered before noon at the usual
rapid French rate. I sat through a long lunch-
eon with a British General and his mess and
found it the longest meal I had ever encountered.
Immediately afterward I begged off from the
afternoon program of work and asked if I might
go to my billet and lie down until the next mom-
164
THE ZONE OF THE ARMIES
ing as I was a bit seedy. A nice English Medi-
cal Officer took me there in his car, returned
with another one and within the hour I was
packed off willy-nilly and resting in the Officers'
Ward of the hospital in the town, with a very
frank case of pneumonia which had been in
process of development when I left Paris and
which my long ride in the open motor had not
benefited to any great extent.
I was an entire stranger to all the Officers
there, but no one could have received more de-
voted, thoughtful care than was lavished on the
American Cousin by his British kin. When the
bad days were over and I was able to be up in a
steamer chair, my room was full every afternoon
of nice British officers. They brought me things
to read and things to eat and things to smoke
and things to drink and sat all over the shop and
laughed and talked and gave me very clearly to
understand that I was not a stranger in a
strange land, but at home and with my own
people. I cannot conceive of any finer, tactful
care than that shown to me, a sick stranger
165
THE DOCTOR'S PART
in the little hospital at M . There was cme
good looking youngster who came often to see
me. He belonged to the Ancient Artillery and
wore the absurd baggy knickerbocker riding
breeches which are a mark of that organization.
One afternoon, I got up from my chair and
floated uncertainly over to my clothes in the
closet and extracting one of my cards from a
pocket, tendered it to him by way of formal
introduction. He took it with a quizzical grim
and without looking at it, said, "That's very
nice of you and I am glad to have the card,
but listen a minute and see if I really need it."
Then he started and gave correctly, my full
name, age, place of birth, year of entry into
the American Army, date of departure from
the United States, date of arrival in France
and wound up with, "You are at present living
with your wife and two children at the Hotel
Regina in Paris and if you will give me a mes-
sage to Mrs. Church, I will guarantee that it
will be in her hands within twenty minutes."
I asked him respectfully whether he was just a
166
THE ZONE OF THE ARMIES
plain seventh son, or whether it was a family
failing. He solved the puzzle by telling me
that he was the Intelligence Officer and that it
was his business to know all about any one
who came into that part of the British lines,
which absolved him from the suspicion of any
uncanny powers. I did give him the message
and he telephoned it to Paris on his special wire
and it did get to its destination within the
promised twenty minutes.
I neglected to say that the last thing I
heard on the day of my admission to that hos-
pital, just as I dropped oj6P into a feverish,
cough racked sleep, was the roar of the "Arch-
ies," the anti-aircraft guns, as they vigorously
shelled a Hun machine which was over the town.
CHAPTER V
TRANSPORTATION
The old saw runs, "First catch your hare."
In order that the wounded in war may have the
advantage of the necessary treatment, it is re-
quisite that they be collected and transferred to
the different stations established for this pur-
pose. All transportation comes under three
general heads : first, that of hand carriage, sec-
ond, by vehicle, either horse or motor driven,
third, carriage by train or boat. All are
important and occupy a definite place in the
sanitary scheme and each one presents its own
special problem. The collection by hand is
that which is first in the order and involves the
moving of the wounded from the place where
they have fallen to the next station. It is hard
and trying work, made more so by the fact that
much of it has to be carried out through the
168
Transport OF Wounded by Litter through a Trench.
Wheel Litter Transport.
TRANSPORTATION
trenches where walking is difficult even when
not encumbered by a burden. Due to the range
of modem Artillery fire the approach trenches
may mean a matter of one or two miles through
which litters must be carried, although this is
obviated at times by evacuation over the normal
ground level at night when darkness gives rela-
tive protection to the working parties.
This class of work is done in the Regiment,
by the Regimental Litter Bearers, who form an
integral part of each Regiment, and they are
supplemented by the personnel of the band if the
Regiment has one. These bearers are supposed
to clean up for their own Regiment and see
that the wounded are carried back to the first
aid station. If further hand transportation is
necessary from this point it is furnished by the
Division Litter Bearers, who are held in re-
serve by the Division Surgeon and sent in where
their services are most required. In many cases
the wounded are evacuated direct from the first
aid posts by ambulances which are now, in the
vast majority of cases, motor driven. In addi-
171
THE DOCTOR'S PART
tion to the Division group of bearers, there is
another supplementary group which belongs to
the Army Corps and is under the orders of the
Corps Surgeon and used in the same manner
as that of the Division.
The work of these carriers of the
wounded is hazardous as well as being hard
physical work. The French say that
"all shells are blind" and many men of the San-
itary Corps have lost their lives while trying to
save those of their fallen comrades. It has al-
ways seemed to me that much credit should be
given to these patient searchers for the wound-
ed. They have none of the spirit of the chase,
the excitement of conflict, the stimulation of
battle. It is their lot to plod along in the shell
shattered area and clean up the muss that their
combatant brothers have made. The wastage
has been high among them although I have
never seen any published statistics in regard to
it. Many expedients have been tried to expedite
this hand labor. In the trenches themselves,
much thought has been given to devising a litter
172
TRANSPORTATION
which will adapt itself to the narrow and tor-
tuous len^h of the steep walled ditches which
make up these systems. Some of them have
been fairly successful, but in the main, the
French have depended on the regulation Franck
litter or on rude improvisations constructed of
poles and canvas. One form, however, is in ex-
tended use although it has no place in the
trench proper. This is the wheel litter, and bj
its aid one or two men can transport a loaded
litter with the minimum exertion since the load
is transferred from them to the supporting
wheels. They will go almost anywhere that a
wheelbarrow can be pushed and are extremely
practical. I think that the most satisfactory
one that I saw in operation was conducted by
two surly looking Boche prisoners presided over
by a French guard. At the beginning of the
war the French were almost entirely dependent
for wheel transportation on horse drawn ve-
hicles. There were plans for motor ambulance
sections, but only a few of them were in actual
operation and the most of the transfer was done
173
THE DOCTOR'S PART
either by the little two wheeled ambulances or
their big brothers with four. It was a very
short time before the superiority of the gas
engine over man's patient friend and ally, the
horse, became evident, and practically every-
thing was turned over to the gas driven car.
An orderly system was rapidly evolved in the
operation of these and at the present time the
make up of the Sections is not radically differ-
ent from what it was in the first days of their
use. There were mechanical questions to be set-
tled of course, in regard to construction, type
of engine, weight of car and capacity of the car
for wounded. Some of these problems took
much trial for their adjustment and others set-
tled themselves very promptly by the aid of
practical experience.
As an example of the latter, there
is the method of putting the litters in
the ambulance. Each car has a capacity
of a certain number of litters, each carrying its
wounded man ; some three, some four and others
five. This necessitates that some of the litters
174
TRANSPORTATION
shall be suspended above the floor of the car»
Some one seeking to devise a method by which
the wounded should travel with as little shock
as possible, devised the scheme of suspending
these upper litters by straps which were at-
tached to the uprights by coiled springs. It
was thought that in this way the jar of the road
would be taken up and much added to the com-
fort of the patient. It was very quickly dis-
covered by those who drove the motors that the
reverse was the truth. The suspended patients,
in addition to having the inequalities of the road
accentuated by this system of suspension, were
subjected to a back and forth swing, — thrust,
which was practicably unbearable. You can
readily understand it if you will imagine your-
self with a shattered thigh on a litter which is
swaying back and forth from head to foot with
each move of the motor and grinding together
the two ends of the splintered bone. The man
who was placed on the floor of the car was the
fortunate soul and the drivers brought com-
parative peace and comfort to the inhabitants
175
THE DOCTOR'S PART
of the upper tier by boring holes in the wooden
sides of the car and lashing the oscillating
stretchers fast and immovable. It was only a
short time before the spring suspension, or any
suspension, was looked on as obsolete and the
cars built with channeled runways into which
the shoes of the stretcher fitted. This method
has persisted and has not only made things eas-
ier for the sorely tried passengers, but has
facilitated the question of loading.
There were long and sometimes bitter argu-
ments between the advocates of the light and the
heavy type of car and each side claimed for its
preferred type many advantages which probably
did not exist and overlooked others which did. It
was finally demonstrated that there was a place
for both kinds, and thereafter "the tumult and
the shouting died." To speak of a product so
well known as the Ford motor can scarcely be
considered as advertising. Many of this make
of automobile were taken to France and there
was much discussion as to the merits of them for
the work to which they were put. As with the
176
TRANSPORTATION
general argument for the heavy and light cars
they had their partisans and those who opposed
them. The early ones in use did have several
faults which were overcome by later modifica-
tions. The long overhang of the body put an un-
due strain on the supporting sills which were
prone to break and this added weight was also
too great a tax on the 8 leaf rear spring. When
the sills were made stronger and another leaf
added to the spring this objection was over-
come. Their lightness was an advantage inas-
much as when one ran off the road it was a
simple matter to put it back by the aid of four
or five men, and there are always four or five
men on any of the roads in the Zone of the
Armies in the France of wartime. Due also
to their light weight they will go, and can be
driven where heavier cars would "bog down."
I found the French in the Vosges mountains
very much in their favor for use in that pre-
cipitous country. On the other hand I heard
that they did not wear as well as some of the
more expensive cars and were an undue expense
177
THE DOCTOR'S PART
for upkeep. I hold no brief, either for or
against them, and I have mentioned these facts
merely because they are really a national insti-
tution and I have been many times asked as to
their utility in this class of war.
The French have adopted for their heavier
type of car, a body which holds five recumbent
cases, four of them on the channeled rimners
already referred to and the fifth on the floor of
the car underneath them. This was an evolution
of the four case body and it can be readily seen
when we multiply one car by the twenty, which
make up a section, and those twenty by the num-
ber of trips made that the addition of even one
case to the carrying capacity of a car is a very
appreciable advantage in the question of evacu-
ation. The personnel of these Sections is about
forty men and presided over by two commis-
sioned officers. They are self-contained units,
and carry their own cook and tentage to shel-
ter them at the sector at which they are at
work. They are, as is all Motor transport in
the French Army, under the direction of the
178
TRANSPORTATION
Automobile Service. This does not mean that
they have their duties prescribed for them by
this service, but that so far as mechanical di-
rection goes they are responsible to it. Their
spare parts come from it and the replacement
cars to take the place of those shot up or worn
out. So far as their actual running duty goes,
they are under the orders of the Chief Surgeon
of the Sector in which they work. He lays out
their schedule and the Officers in command of
the Sections are held responsible that the sec-
tion does its work in accordance with the di-
rections it receives. They are a roving or-
ganization, here to-day and gone to-morrow,
and they foregather where there is the shock
of battle and the blood flows fastest. Natural-
ly there is but little work for them in a peaceful
sector and they are drafted to those in which
there is real activity. They have proved de-
voted in their duties and have gained much
commendation from their brothers in the line
who are dependent on them for transport when
German ammunition has laid them low.
179
THE DOCTOR'S PART
Prior to our entry in the war a very appre-
ciable proportion of this collecting work was
done by American volunteers who worked under
two different organizations, the American Am-
bulance Service (later the American Field
Service) and another series of sections organ-
ized under the direction of the Red Cross. This
service was built up from small beginnings and
in the course of time came to be an important
adjunct to the French sections engaged in the
work. At first there was some difficulty due
to the fact that it was, as is universally the
case, difficult to adjust questions of discipline
in a volunteer organization. When this condi-
tion was recognized it was met by measures
which did away with the objectionable feature
and thereafter the functioning of the service was
smooth and satisfactory. The French system
was adopted and the make up of the volunteer
sections was identical with those of the regular
French army. A French officer was put in com-
mand of each section and the American volun-
teers worked under his command. The per-
180
TRANSPORTATION
sonnel was under a pledge to serve with tke
section for a minimum of six months and manj
of them renewed the obligation.
The result of this voluntary aid was an ad-
vantage to the French in the material help af-
forded and to our own country in the experience
and training it gave to the men who after our
entry in the war were qualified to do the work
themselves for their own people. The French
were entirely appreciative of the efforts of these
two services and at a time when there was much
speculation as to what was to be the attitude of
America in the war the presence of these men in
this active capacity did much to retain the con-
fidence of our Allies as to our ultimate inten-
tions. I heard many comments by my French
friends in respect to the good work accom-
plished by these American Sections and they
were always accompanied by warm appreciation
and entire affection. At the beginning of our
part in the war these services were absorbed by
our army and many of the personnel remained to
carry out as enlisted men and officers under our
181
THE DOCTOR'S PART
own flag the duties they had learned as volun-
teers with a foreign force. The duties which
fall to the Ambulance driver are by no means a
sinecure. They call for resourcefulness, for
self reliance, stamina and a disregard for per-
sonal safety. To drive a smoothly running
motor on a good road with clear daylight or
adequate illumination by lamps is a very dif-
ferent proposition from nursing a heavy car at
a low rate of speed over a road pitted with
shell holes and subjected to intense bombard-
ment.
No one who has not had the doubtful pleas*
ure of riding in an ambulance under such con-
ditions can appreciate what it means. There is
no darkness so black as that of these cloud
draped French skies where light comes only
from star rockets. One cannot see ; he must go
I think by intuition. There are a thousand
things to confuse and puzzle : the general lay of
the road must be in the driver's mind, with all
shell holes and obstructions registered in his
mental processes and even so he has no assur-
182
TRANSPORTATION
ance that since he has last traversed the way
of his coming some fresh shell burst has not
opened up a new pitfall to catch him and his
wounded cargo. He must dodge the traffic of
the "ravitaillement" convoys, the camions which
each night bring up to the front lines over
these blasted thoroughfares the supplies for the
front that can come up only under the shield-
ing protection of the darkness. He must expect
damage to his car and to himself by shell burst
and carry on as long as he can even if wounded,
or put his car again in condition to travel if
within range of human possibility. And he
must make his repairs in the dark, by the sense
of touch and with the certain knowledge that
other shell may come before his task is finished
and blow him and his machine and his wounded
man in a gory tangle of torn flesh and broken
wood and twisted iron far past any chance of
recognition.
He must expect to drive through gas
when his sight is not only obscured by the
cloud but by the mask he wears for protection.
183
THE DOCTOR'S PART
He must forget that there are hours when the
human system cries out for rest and repose, and
so long as there are wounded waiting for trans-
port from the front to their place in the rear
of the line he must keep his heavy eyes open
and with clear brain and a high heart shut his
teeth tight on the sense of hunger and fatigue
and cold and danger and drive, drive, drive;
until the front is clear so far as his sector is
concerned, and then, perhaps if the fates are
not kind to him, hustle off to an adjoining sec-
tor to lend willing if tired hands to those who
need them there. Twenty-four hours, thirty-six
hours at a stretch is no novelty in his day's
work and he does it with the cheerful sang froid
of the clean bred American who knows how to
spend and spare not when he considers that
it is "up to him." This is the class of work that
was so well done by these two volunteer organ-
izations and it is little wonder to me that the
French were fond of these boy drivers of theirs
who held their chins high and with a cheerful
grin and an impudent cigarette in the corner of
184
Ambulance Drawn by Dogs.
Sanitary Do(
Red Cross Dog "-
Wounds.
-Dressing his
TRANSPORTATION
their mouths drove through Hell with entire
apparent unconcern. They did not all drive
through though, for sometimes the red flare of
the burst carried the steel fragments home and
stilled the brave hearts beneath the rough
clothes.
Cross guarded mounds, from the Vosges up
through Verdun and on beyond the plains of
Picardy, mark where these young seekers of the
Great Adventure have found that which they
had so often regarded unafraid with their frank
boyish eyes. During the latter part of my ser-
vice in France I was sorry to see in one of the
papers of Paris which is printed in English a
rather bitter and I thought unwarranted criti-
cism of the many young men who made up the
personnel of these two services. I had the op-
portunity to know many of them and I am glad
to bear testimony that those I saw were straight
and clean and unafraid. They were a credit to
our Great Republic and the memory they left
after them is one that will remain green in the
hearts of our allies and is one which we should
187
THE DOCTOR'S PART
cherish, the record of fine service done un-asked,
of labor and strength and life given because
thej believed the cause was their cause and in
this way only could they at that time bear testi-
mony.
At the time we took our place in the ranks
of those opposed to the Hun menace this service
was taken over and administered by our own
army and it was my good fortune to make, un-
der General Pershing's order, an inspection of
the American Field Service that I might report
to him their availability for incorporation into
our own forces. In company with the Director
of the service I not only went over the complete
installation in Paris, where the central offices,
the receiving barracks and the various repair
and construction shops were located, but in
company with him I spent some days at various
points of the front that I might be in a posi-
tion to report not only on the general organiza-
tion and the material resources, but as to the
actual working conditions of the sections under
field conditions. This tour carried us from the
188
TRANSPORTATION
always interesting Verdun sector on the South
up the line to that man made hell the Chemin-
des-Dames. We left Paris in the early day of
a summer morning in a large and perfectly
capable Peerless car driven by a taciturn young
man who was as capable as the car and exacted
from it relentlessly as much kinetic energy as
was potentially stored under the long black
engine hood.
We went out over the smooth straight line
of the Route National to Montmirail where
stands one of the many monuments of France,
this one now scarred but not broken by the
German shells which struck it during the hard
days of 1914. We ate a cold lunch in the car,
and literally I do not remember that I ever had
a meal go so far, as we were reeling off steady
mile after mile at fifty, fifty-two and fifty-eight
to the hour. Travel by motor is not regarded
as a pleasure in France to-day ; it is an errand,
a method of annihilating the space that exists
between "here" and "there", and your chauffeur
gives his entire and silent attention to seeing
189
THE DOCTOR'S PART
that there are no wasted seconds in transit. I
have a private suspicion that he sometimes
makes it a sporting proposition with himself.
There was a big French staff car in front of
us which I soon realized must be passed, though
why I do not to this day know. With my mouth
full of cold chicken and hard boiled egg I
watched the speedometer, which read in miles,
creep from fifty to fifty-five, jump to sixty and
then while the needle danced drunkenly above
sixty-eight there was the throb and roar of
passing engines and we sailed triumphantly
away ahead.
The speed laws of France to-day are
very explicit and entirely exact: they are
based altogether on the power of your engine
and your own confidence in your maker, — of
your car. We visited a school of mechanics
and construction where the personnel of the
service was sent for a course in both the theory
and practice of driving and repairing cars and
in the technique of handling and managing con-
voys. There were lectures by officers of the
190
TRANSPORTATION
French Automobile Service with blackboard dia-
grams and formulas which looked decidedly
technical, and there was a well equipped work
shop where these student volunteers were taught
to take to pieces and assemble various makes of
engines and to make such repairs as would fall
to the lot of the ordinary, or better said, ex-
traordinary, chauffeur under the many adverse
conditions which were thereafter to be his nor-
mal daily surroundings. It seemed thorough
and practical and the Director told me that it
was a manifest advantage and that in this way
they were able to turn out men who in addition
to being good drivers had also sufncient tech-
nical knowledge to render them of value for
positions which necessitated more than an un-
derstanding of the requirements of the throttle
and the brake. The lectures were all in French,
and I am sure that the absorption of this tech-
nical lore in a strange language was not alto-
gether a light and easy task. It was good prac-
tice however since their duties would lie with
those who spoke no other language and with the
191
THE DOCTOR'S PART
easy facility of youth they seemed to be entirely
undisturbed by the fact that they must think in
a foreign tongue.
From the school we went on through Chalons-
sur-Marne and St. Menhould and Clermont-en-
Argonne and up to a Section which was operat-
ing behind the Avocourt sector in the Bois de
Hesse. This is all N.E. of Verdun and there
has been much hard fighting in the country and
the life of a Section on duty in this vicinity is
sure to be a busy one at some time of its stay.
The day we were there was one of comparative
quiet. Comparative quiet on the western front
should not bring to the mind of any one an
idyllic, lazy, drowsy summer day. The word
"comparative" was I think invented for battle
use and it is easy for one to say in regard to
existent conditions, it is "comparatively quiet
to-day." I have seen times when I thought
that indeed comparisons were odious. As there
is always motion in the sea even in time of ab-
solute calm, so on this tossed and troubled field
of war, comparative quiet does not mean a cessa-
192
TRANSPORTATION
tion of gunfire, an absence of war's furors. It
is, I think, in line with the leading western citi-
zen's eulogy over the body of the dead bad man
of whom the best he could say was, "Brethren,
he might have been a damn sight worse."
We inspected the quarters of the drivers
which were the usual French billet, barns and
sheds commandeered for the purpose but cleaned
and in order with commendable American neat-
ness. We looked over the row of waiting Ambu-
lances and lifted hood after hood to see if we
could find a dirty engine, which we did not, and
we had our attention called by the fresh faced
drivers to the jagged holes in the wood work
or the white scars on the iron where Boche shells
had left their biting mark during such and such
a run. They were proud of those scars of
service and I do not blame them. We went with
the American Section Chief, for there is an
American Assistant Chief as well as the French
officer who is in supreme charge, up to the first
aid post which drained the front trenches of this
sector. There we found an Ambulance pro-
193
THE DOCTOR^S PART
tected from shell fire behind some debris and a
segment of still standing wall and down in a
dugout two blase youths who were playing list-
less casino and complaining that it was unutter-
ably stupid that day with no excitement and
nothing to do. From here we went on ahead
through the green of the Forest to one of the
French observation posts presided over by a
smart little French Corporal and one or two
men. From this there was a good view of the
German lines not far distant and with the aid
of a pair of good glasses it was possible to make
out very plainly the trend of the enemy trenches
and the tangled mass of his barbed wire which
loomed on the other side of that bare waste
of "No Man's Land."
The next day we spent in looking over var-
ious sections in the vicinity of Verdun and in
the evening were off again to the Northeast of
Verdun where we dined at the mess of one of
the sections which was on duty in the Sector
comprising the Mort Homme and Hill 304«,
points which at that time were fiercely disputed
194
TRANSPORTATION
bj both the French and Germans. This was
just prior to the drive in July 1917 in which
the French retook both these points and ex-
tended their lines to the point they had occu-
pied at the time of the initial thrust of the
troops of the Crown Prince in his hapless quest
for the pass at Verdun. I had been in hopes
of making this visit at the time of the Infantry
assault, but got there too early and had to con-
tent myself with the Artillery preparation. As
a spectacle this is all that could be desired and
as for overwhelming insistent noise it goes far
beyond anything that the imagination can con-
ceive. The headquarters of this section were
at that time at Villes-sur-Cousines (since this
ground has passed well into French control
there seems to be no reason for avoiding names)
and here were the cars of the unit, save those
which were on duty at the different advance
posts, and here were the repair shop and the
quarters and mess of the men who made up the
section.
After a cheerful supply with the personnel
196
THE DOCTOR'S PART
I set out with the French Lieutenant in
command to inspect the forward work of the
Section. The evacuation of the wounded, save
in time of intense activity, was carried on in
the dusk and in the night, since much of the road
traversed in doing this lay within plain view of
the German lines about the Mort Homme and
Hill 304 and they were not backward about
shelling any moving transport on the roads.
We went in a Ford car up through Dombasle,
from which the section had been recently shelled
out, over roads which grew progressively worse,
until we came to the town of Montzeville. The
roar of the guns grew louder as we advanced
and before we reached Montzeville we came into
the area in which French batteries were posted,
and in action. So well and carefully is artil-
lery now concealed that it was a difficult matter
to make out the location of the batteries save
from the flash of the guns themselves. It is
distinctly disconcerting to have a battery of
which you have no previous knowledge, fire a
salvo from your immediate vicinity; to hear
196
TRANSPORTATION
the shells tear their way over your head and
to feel the shock of the concussion. It shakes
you mentally and physically and the first of
these literally raised me off my seat to the
amusement of the French Lieutenant. The
Germans were searching for these batteries with
good sized shells and the black clouds of their
bursts dotted the hills all about and the sharp
roar of their explosions added to the noise of
the French artillery. One dropped on a bat-
tery near the road as we came along and killed
one of the gun crew. They brought him in to
the aid station, his face covered with a cloth
through which the red stains showed.
His body was placed in an angle of the wall
on the stretcher and excited no comment and
apparently no curiosity. One chatted or
laughed or smoked a foot away and it all seemed
a matter of course; that which had happened
to him to-day might happen to any one to-
morrow and was only a part of the day's work.
Of course that is the only rational way to view
it, for war is a gamble for the individual at
197
THE DOCTOR'S PART
"best, but it seemed very close and personal to
see this healthy sweating peasant turned in a
minute from a living entity to a mangled shape
whose only further end was burial in one of the
cross crowned little cemeteries which mark so
much of France to-day.
Montzeville itself was a husk of a town. Of
course no one lived there save the troops who
were on duty in the immediate vicinity. The
houses were roofless shells, pitted and scarred
by the German gunfire and the once tidy street
was pock marked with shell holes and littered
with debris. We left the Ford car here and,
after visiting the little dugout which pro-
yided shelter for the small number of Sani-
tary personnel on duty and the wounded
from the nearby batteries, I changed to an
Ambulance which was to go forward to Esnes,
to wait there during the night on emergency
duty ; to bring back any cases which might not
be able to wait long for treatment. This am-
bulance bore the mark of shell explosion and the
boy driver who was in charge of it told me
198
TRANSPORTATION
that it was quite customary to be shelled on
the way to Esnes, and especially at one point
where the road made a sharp turn and ran for a
way parallel to and in plain sight of both the
Mort Homme and Hill 304. He told me that
they usually ran with two men on the front seat
so that if the driver were hit the other could
take the wheel if he himself escaped. As I
was not myself a competent chauffeur I won-
dered what would be the fate of that particular
car if anything happened to him at the turn
that night.
We picked our way slowly in the fad-
ing light over a road that was bad because
it was pitted with shell holes, littered with vari-
ous obstructions and covered with a coating of
greasy mud. All around us, before, behind and
on either side the French batteries of large and
small caliber were in action and the air was
full of the scream of the departing shell and
also punctuated by the drone of the German
projectiles which were searching for them in
counter battery work. It was slow going and,
199
THE DOCTOR'S PART
if progress was no more rapid under these con-
ditions when it was possible to see the way, I
wondered what it was when you had to feel out
your route in inky blackness, threading a pre-
carious way through the maze of transport
which each evening crowds the road. Every-
thing along here bore testimony to the fact
that it was the scene of conflict. There was
the active evidence of the French batteries in
action and the burst of the German shells in
reply.
Everywhere were the craters of former
explosions and new ones forming at various
points. What few trees remained were riven
and splintered, hanging their withered heads in
token of the blast which had swept over all this
once fair landscape. There is an incongruity
about a battleground in a cultivated country.
It seems all wrong somehow ; not to belong ; as
though some black hideous excrescence had ap-
peared on a flowering plant. There yet remain
enough of the landmarks of happy peace to
show what had existed before the scorching
^00
TRANSPORTATION
breath of war and passion had swept over every-
thing turning the green to brown and breaking
and twisting into fantastic shapes all the home-
ly marks of normal existence. We crept on in
the glow of the sunset up the battered road
going straight toward the Mort Homme which
showed as a dominant height wreathed and
dotted with the white bursts of the French
shells which sprang up one after another over
its face as the shells landed and exploded. We
were not shelled at the turn this night, but as
we turned and began our run parallel to the
Hill 304 on the road which ran into Esnes,
(pronounced, "N") German shrapnel began to
break before, behind and on either side of the
road. I do not think they were looking par-
ticularly for the ambulance, it was just a part
of a methodical search for the batteries which
were in action against their positions. None
of the shells burst very close to us, the nearest
about two hundred and fifty feet away I sup-
pose, but it was enough to give one an idea of
sudden death or mangled after existence.
201
THE DOCTOR'S PART
We jolted into Esnes over a road which grew
progressively worse and was littered with brick
and fallen masonry and tiles which had been dis-
lodged from the houses of the little village.
Esnes was Montzeville over again, only accen-
tuated. No one was here either save the sol-
dier garrison and it seemed a ghost of a place
in the fading light of the summer twilight. The
house fronts without their roofs shone gray
and ghastly in the twilight and the shell holes
in them were black and ragged. Shells were
bursting in many parts of the town and their
explosion was followed by the downrush of
masonry and the tinkle of falling tiles. We
went on up a street past the body of a dead
horse whose stiff legs pointed grotesquely up
to heaven, the one remaining evidence, save some
dark stains on the ground, of where eight men
of the transport train had been caught in a
shell explosion the night before and their lives
blown quickly out. Even as we came up a
fatigue party came out with picks and shovels,
and under the constant urging of a non-com-
202
TRANSPORTATION
missioned officer hurriedly put this last dis-
torted evidence under ground. Everything is
done hurriedly that can be so accomplished, in
this region where death drops unexpected from
the skies and no man is safe save he be protected
by solid earth and rock above his head.
The first aid post was in the cellar of an old
chateau. The usual type, the brick and stone
arches reinforced by stout timber uprights to
make assurance as doubly sure as might be. The
entrance was down a flight of stone stairs and
the interior dark and low and crowded with
bunks, wounded and the personnel who cared
for them. Coming in from the light one had to
go slowly in this c usky cave to avoid stepping
on some silent figure which waited with charac-
teristic stoic patience his turn to be transferred
to some place where he should receive care for
his wound, clean bed and quiet surroundings.
It was all rather like one of Dante's word pic'
tures. The gloomy darkness punctuated by
the flare of the torch like lamps and the candles,
the smell of blood and drugs, the thick shadows
SOS
THE DOCTOR'S PART
which lurked in the corners and threw into re-
lief the staring white of the fresh bandages and
the pale gray of the upturned faces. It seemed
very fitting somehow that the setting of the
picture should be underground, for it was cer-
tainly associated with death and all that goes
with it.
I made the rounds of the little estab-
lishment with the Surgeon on duty there and
he explained his cases to me and the means he
had of caring for those who came to him for
this the first step on their road to cure. There
is not much, of course, which can be done in
a unit of this kind: only the simpler kinds of
work. One stops hemorrhage of course, if it
exists, injections of Anti-tetanic serum are ad-
ministered, splints are adjusted and the men
given broth and stimulants if required. The
first aid post is just a check point to insure that
the wounded who go from it shall leave in the
best shape possible to make the trip to the
unit further back. It makes no pretence at
anything in the way of formal work. All that
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TRANSPORTATION
is done, however, is entered on the tag which
is twisted on a wire on a button of the wounded
man's coat and he arrives at each station with
a readily accessible record of what his injury
is, and of the measures which have already been
taken for his relief. The urgent cases, those
which should receive prompt surgical care, are
so marked by a special tag. The whole system
is along the line of that key word, "triage" — •
sorting, which as I have stated is very nearly
the base on which this system of care of the
wounded is built.
There were not many seriously wounded in
this dark little cellar this evening and I was
spared the always harrowing sight of the
mangled men who uncomplainingly bear in-
juries which seem beyond the control of human
fortitude. At certain posts, such as this,
where there is apt to be need for transport at
almost any time, a motor ambulance is kept
always on duty throughout the twenty-four
hours. It was to replace the one then there
that we had come up, and the boy who was my
207
THE DOCTOR'S PART
driver from Montzeville was due to wait
through the long fire swept night until he in
turn was relieved, or obliged to feel his way out
in the Stygian blackness with his wounded. As
I have said, all these highways of the front are
each night subjected to searching shell fire in
order to harass as much as possible the service
which brings up to the front lines the stores of
food and ammunition and other necessities
which may not be safely transported by the
light of day. And so, soon after I had finished
my inspection, the Surgeon suggested with true
French tact, that it would be safer for his
wounded if I could find it convenient to make my
way back with as little delay as possible since
the hour for the evening "strafe" was approach-
ing. I could see no good reason why I should
subject those already wounded men to further
risk, and my mind reverted to the dark stains
on the ground and the grotesque dead horse at
the bend of the street — the mute testimony of
what the German hate had accomplished the
night before. I am not at all ashamed to say
^08
TRANSPORTATION
that it was at least one word for the wounded
and one for myself, for I have never made any
pretense that I enjoyed being under shell fire.
I do not know whether one does get so accus-
tomed to it that there is no eerie creep at the
back of your neck when you hear the hoarse
noise of an oncoming shell which gives only the
advertisement that it is coming, but no informa-
tion as to its exact destination. I do know,
from personal experience, that for me, at least,
there was always a tense moment until the burst
had demonstrated that that one, anyhow, did
not bear my nmnber. And so I was quite
ready, having seen all that I had come for, to
take my place in the front seat of the loaded
ambulance for the return trip.
We crept slowly out through the ruined little
village where the shells were beginning to fall
with increasing frequency, over the battered
road and slowly on account of some engine
trouble up the rise; along the parallel stretch
of road where the black shrapnel still burst,
around the corner and with our backs to
^09
THE DOCTOR'S PART
the Mort Homme and the lines back
through the bleak blasted terrain again
to Montzeville, where we found the same
quiet confident Poilus and where the dead
cannonnier still lay, his feet in their worn, hob-
nailed shoes more grotesquely stiff than ever
and the stains on the cloth over his face turn-
ing from bright red to a dull brown. We
lingered a while in front of the little dugout,
chatting with the Sanitary personnel, and then
back again through a throng of horse-drawn
wagons, of camions, of diminutive "burros"
which with their loads on their backs went up
into the trenches themselves ; through all this
which made up the nightly "train de ravitaille-
ment" to our night's lodging in billets in a
sleepy French village where the sound of the
ever pounding guns hammered in my ears like
a pulse of the night. The next night, a German
shell dropped on the place where I had been
standing in front of the little dugout, and
among those who paid the toll was one of the
Ambulance drivers of the section, a lad whom I
210
TRANSPORTATION
had laughed and talked with the night before.
And a few days later, back in a town further to
the rear, on the same road a waiting convoy
of motor ambulances came under the fire of
high explosive from German 150 mm. shell and
two more of the Section paid the price for their
service. The next evening, I visited another
post of the same character, further to the
North where our fast flying car had transported
us on our inspecting tour.
To reach this post we went through
a town, deserted of course, which the
Germans were vigorously bombarding: went
through it on the doubtful advice of a
French soldier who seemed to think that it
was not advisable to do so in face of the shell-
ing. I am sure he was right, for when we had
careened through the splintered streets to the
roar of shells and the crash of smashed houses
and were drawing peaceful breaths on the other
side we were informed by another blue clad
Poilu that our first informant was by way of
being an idiot and that the town we sought did
211
THE DOCTOR'S PART
not lie in that direction at all, but that we
should have taken the first turn to the right on
the other side of S , the cheerful village
we had just safely passed. And so back again
through S and its harried thoroughfares
and tottering houses. The second passing
seemed to me entirely gratuitous and I could
have cheerfully argued with our first mis-
informant but we took no harm and found the
right hand turn and the way we were seeking.
The view as we approached the little town, or
village, where lay our Aid Post was interesting.
It was a relatively flat country, rolling a little,
and the German lines lay on a long ridge in
plain view and marked by the constant burst
of the French shells. It was fascinating to
watch these; they danced up in fierce white jets
or brown columns, which sprung up eagerly at
first and then lazily dissipated as they lost their
first fierce energy and drifted away on the
wings of the summer wind. They appeared
with no apparent regularity as to lateral direc-
tion. Sometimes there were four or more
212
TRANSPORTATION
which all flowered at one point, the evidence that
there was directed fire "by battery," and at
other places single clouds showed that the bom-
bardment was in slow order. The color of the
bursts varied from the woolly clouds of the
shrapnel, which hung in the sky, to the sudden
upspringing from the earth of an inverted
cone of gray and black and dun yellow, where
the high explosive sent up its cloud with the
riven earth and rock from the point of its im-
pact. In between all was drowsy summer peace.
The fields were high with grass, the summer
twilight hush was in the air and the birds ranged
over the fields in evening song before they
sought their roosts. Scenes of this sort are
incongruous ; it is the contrast between the
struggle of man in his passion and the struggle
of nature to hold to her own inflexible order
the things that are hers. And finally, nature
will conquer, for when the "shouting and the
tumult dies, the Captains and the Kings depart"
all this will come back to the purpose for which
it was designed and the scars of man wiU heal
213
THE DOCTOR'S PART
on the landscape and remain as faint evidence
of spent passion.
At the outskirts of the village we changed
from motor transport to walking, and I
noticed that our chauffeur carefully turned
the car around, backed in under the pre-
carious shelter of a drunken looking wall
and left the engine running. It is sometimes an
advantage to have a flying start and not be
dependent on the vagaries of a motor which,
with the perverseness of inanimate objects,
shows a disinclination to function. We found
here the same dead town. They do look so
pitifully dead, these abandoned French villages
of the front lines. Everything in them cries
out of the homely life which has been squeezed
out of them. Here, the sign says, is a restau-
rant— the only tangible evidence of it the
blackened wall with the faded letters of the
sign. There, the opened front of some one's
house showing splintered furnishings and tat-
tered curtains which wait the return of the fam-
214
TRANSPORTATION
ily which may be in exile or gone beyond the
possibility of any coming back.
The streets are there but they are not streets,
just echoing canons between gaunt skeletons
of dwellings and littered with debris, battered
belongings and shattered masonry and brick.
It all seems dreary and dead and unaccountably
still. One waits with expectant ear for the hum
of human life, the sound of talk and laughter,
the voices of the children at their evening games
and the familiar human rustle of the homely
peasant world before it puts itself to bed. Of
course you know that it is not, and cannot be
there, but it seems as though it ought to be and
its absence makes the stillness more marked in
this quiet time of the evening hush. And then
you realize that there is no evening hush ; that
you are conjuring up in the eye of your mind
what ought to be in your own place, in the
quiet hills of New England, the fastnesses of
the Appalachians or on the wind swept prairies
— ^wherever it is that memory places these
scenes. The stillness is a mental conception
215
THE DOCTOR'S PART
and the physical senses are keenly aware of the
life which is here, — the life which exists to take
life. With the angry crash of shells, the noise
of their oncoming, of their passing, the noise of
breaking houses and falling ruins, the illusion
of quiet passes and the interest quickly centers
again in the ego and what is to happen to it.
We made our entry here to the accompaniment
of a very lively evening bombardment. Mostly
six-inch shells which with their high explosive
content shake not only your mental self in their
burst but by their physical energy, rack and
rock your very body itself in the violence of
their explosion. They were dropping in all
quarters of the village and it seemed to me dur-
ing our brief quest of the aid post and the
French officer in command of the village that
their frequency increased. One broke in the
street about a square ahead of us and shook
down two uncertain houses in a golden haze of
broken brick and dust and we could hear them
falling in the streets to our right and left as
we approached the partially destroyed building
216
TRANSPORTATION
which sheltered the Headquarters of the Com-
mandant and served also as the station for the
first aid post and the waiting ambulance. We
found a French soldier on guard in the court-
yard of this building and in response to our
inquiries were told that the French Major in
command of the Sector was dining in the cellar
with the Ambulance driver, the American lad
who was on duty at this time in this harried
village. We expressed a desire to see the Amer-
ican and begged that the Major should not in-
terrupt his evening meal on our account. In
answer to our message, taken by the steel
helmeted orderly, both the Ambulance boy and
the Major emerged from the dark doorway of
the cellar, the latter wiping from his long gray
mustaches what I am sure must have been per-
fectly good, "Pot au feu" or "Petite Marmite."
One of the gravest crimes you can commit is to
interrupt a French soldier at his meal and I
was instantly contrite and apologetic. I was
assured that it made not the slightest differ-
ence ; that he had finished ; that he was glad to
217
THE DOCTOR'S PART
be interrupted ; that it would be a pleasure if
I would come and conclude the very poor repast
with him. I regretted that I had already
supped and assured him that I had come only
to see the conditions under which the Ambulance
Service worked at his post. He assured me of
the satisfactory character of the service af-
forded, indicated the waiting motor car in the
corner of the court, and then asked me, with an
earnest and thoughtful air, if I had happened
to notice as I came into the village that "there
was of a bombardment there this evening?"
Just then a shell exploded across the street
and cast bits of flotsam and jetsam over the
high wall into the court, and rather than appear
too stupid, I acknowledged that I had had a
Tery grave suspicion that such was the case
during my short walk through his altogether
charming village. He became more animated
and told me that he was each evening the recipi-
ent of attentions of this kind but that this
evening seemed to be the occasion 'of an extra
218
TRANSPORTATION
effort for some reason, or as he expressed it
"Ce soir le Boche est tres, tres mechant.'*
What the Boche was angry about he did not
state. Continuing, he said that of course he
felt honored by a visit from me, but that this
was no place for me at present; that he was
particularly glad to see me as I was the first
American Officer who had so far visited him
but did I have a motor car near ; that I was not
only the first American Officer who had visited
him, but the first one he had seen, but that in
view of existent conditions, much as it distressed
his sense of politeness he was compelled to sug-
gest that I leave him before my blood might be
on his head. That the shelling was rapidly
growing more intense and that frankly, it was
no place for one who did not have to be there.
I recognized, from the evidence of my own
senses, that there was a measure of truth in
what he said and wishing him good luck and
hoping some day for a more satisfactory meet-
ing we left him in his desolate, shell infested
219
THE DOCTOR'S PART
little village and went back through the streets
which shook with the quickened roar of high
explosive to where the good little motor was
still turning, and in it away through the soft
summer night with our backs to death and
carnage.
Strange as the coincidence is, at this same
village, in the same courtyard, the waiting Am-
bulance driver was killed on the following even-
ing by one of the shells of the "evening hate."
In addition to duty of the kind described, there
is much more which has to be accomplished by
these Sections. It would not be practicable to
split up the motors of the sections, assigning
them to individual stations ; this is done only
in places where there is unusual activity; in
the others, except in time of attack, the evacua-
tion of the wounded is accomplished according
to schedule by cars assigned to the duty and
which make daily fixed runs over an established
route. These "tournee" cars are due at cer-
tain of the collecting points at a certain time
each day and such cases as can without preju-
220
TRANSPORTATION
dice to their condition wait for the daily col-
lection, are held for it. In the event of urgent
necessity, a telephone call is sent in and a spe-
cial run is made.
CHAPTER VI
FRONT LINES
To any one making inquiry in regard to con-
ditions during the time of war, it is natural
that the thing which should have the strongest
personal appeal is just what exists at the actual
point of conflict ; where the two forces come to-
gether. From the standpoint of the medical
officer, this point, while important in relation
to immediate treatment, is only a step in the
complicated scheme which stretches back into
the interior and leads to the ultimate restora-
tion of the wounded man to a state of health
sufficient to make him a possible effective again
on the firing line.
A trench is exactly what the word indicates.
It is a ditch dug in the ground to a depth gov-
erned by the nature of the soil and may range
from a few feet to six, seven, or eight. The
%%%
FRONT LINES
side towards the enemy, the "parapet," is built
up with sandbags. The rear slope is called the
"parados." Along the line of these first
trenches many casualties of course occur, not
only from direct infantry assault, but from the
effect of artillery fire, and it is necessary that
provision be made by the medical corps for the
care of men who are wounded during attacks
of any kind. The first station of the medical
corps for the care of wounded is the "refuge
for wounded." This varies in accordance with
the possibility of construction from a hole in
the trench wall to a well constructed and thor-
oughly roofed dugout, manned by a certain
number of sanitary corps personnel and pre-
sided over by a medical officer and affording
fairly thorough treatment, as far as first aid
goes, for any wounded who may be brought to
it.
The wounded from the trenches are brought
into these refuges, if unable to walk, by the regi-
mental litter bearers and held there until evacu-
ation is possible to the first aid post, which is
223
THE DOCTOR'S PART
farther in the rear. The first aid post is situ-
ated farther behind the lines at the beginning of
the "boyau." A "boyau" is the communica-
tion trench which goes from the relatively-safe
zone up to the first line trenches and derives
its name from its similarity to the exact mean-
ing of the word in French. "Boyau" means in
French, an intestine, and the word was bor-
rowed and applied to these approaches on
account of the tortuous character of their con-
struction, which was necessary to avoid enfilad-
ing shell-fire. The frequency of the refuges for
wounded and the first aid stations is governed
largely by the character of the terrain in which
the operations take place. In one sector which
I visited in the defenses near Verdun, on a
front of some three miles, there were only two
of the communication trenches, "boyaus," and
I think only two refuges for wounded. The
consequence was that all wounded in the trench
on this front had to be brought to one extrem-
ity or the other and from there carried back by
litter to the first aid station at the end of the
224i
FRONT LINES
two converging boyaus. Work at the refuge
for wounded is necessarily of a very sketchy
character ; hemorrhages stopped, first aid dress-
ings applied, and perhaps a stimulant given,
but no attempt at any formal surgical care.
This is deferred until the man is carried to the
first aid post already referred to, and even here
nothing of any importance is attempted; only
that which is absolutely necessary to insure his
safe transit to one of the more permanent or-
ganizations in the rear.
As typical of the circumstances attending
this service, I quote the following account of a
trip which I made to inspect this class of work
in a French sector in a region in France, which,
due to military necessity, must naturally be
without a name.
I went by motor with the officer accredited
to me as my guide and counselor to the head-
quarters of the General commanding the divi-
sion, and there we picked up the division sur-
geon who had the direction of the sanitary work
in the sector. It was a hilly country, but, in
SS5
THE DOCTOR'S PART
view of military necessity, the former trails in
the region had been enlarged and completed
into military roads which would have been most
admirable in any section of our own country.
We went by motor, constantly up hill. At
many places high brush fences had been built to
hide ("camouflage") the road from German
observation. After half an hour we halted in
front of the Ambulance,* one of the front line
units at the end of wheel transportation, except
for Ford ambulances, which went half a mile
further. We walked on through mud and mist
down hiU and up ; over stones and pine needles
until we reached the Poste de Secour, or first
aid station, at the beginning of the approach
trench which led to the front. After inspecting
this, we stepped into the boyau and went on to
the front line trenches. This boyau was a
trench just wide enough for us to walk in and
zig-zagged, so that no great length of it could
be raked by shell explosions. Even in flat coun-
* In continental parlance, an "Ambulance" is not a ve-
hicle for the transport of wounded, but any wio6iZe hospital.
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FRONT LINES
try such walking is not very good, and here it
was up hill all the way and muddy and rocky,
and I slipped and shd and caromed from one
sticky earth wall to another and sweated until
I was like Mr. Mantalini, a "demmed cold,
moist, unpleasant body." The blessed thing
ramified and branched and right-angled almost
as much as a city. I should have been lost with-
out a guide.
In due time we came to the company
shelter for the wounded, which opened directly
into the boyau on one side and on the other
toward the first line trenches which were less
than 40 feet away. The shelter was the usual
type, built into the side of the hill and heavily
roofed with rock and dirt and stones. All the
men in these trenches lived in them and during
shell-fire only six or eight lookouts were actu-
ally exposed in the open. There was some
desultory bombardment at this time, and Ger-
man shells were dropping at various places
along the front. One of the French hospital
corps men smiled cheerfully at me and made a
227
THE DOCTOR'S PART
remark in French, which for a few minutes puz-
zled me. After thinking it over, I realized the
fact that he was not only talking a foreign
language, but that he stuttered while he talked
it and that the idea that he wished to convey
was that to-day the German shells seemed to be
altogether rotten ("p-p-p-pourris") — referring
to the fact that several in our vicinity had not
exploded.
We were met here by the Captain in com-
mand of the sector and went out with him to
make the round of the front trenches, which
were only four minutes from the shelter. He
explained to us that the closest point in his line
was only 20 meters from the German trenches
and asked that we speak softly, as they were
often irritable. We made our way through 300
yards or so, which was his front, and it was very
real and grim and interesting; the still men
opposite their loopholes, the supply of car-
tridges loose in boxes, the hand grenades laid
in readiness and the platforms built to throw
them from. I was allowed to look through a
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FRONT LINES
slit in the steel plate, but for only a moment on
penalty of having some wary "boche" shoot me
in the eye. I saw a waste of jagged barbed
wire and torn earth and some 60 feet away a
line of raw earth which marked the beginning
of militant Germany and behind which, I sup-
pose, watchful eyes were also peering.
It smelled of dead men here; there was one
that I could see hanging in the barbed wire just
outside, who seemed to be a cause of particular
annoyance to the French inhabitants of the
trench. He was provokingly near, but due
to the proximity of the lines they were unable
to get out to disentangle him and place him be-
low ground where he would be less offensive.
The medical man in the sector explained to me
very vivaciously that they had -tried to render
him less obnoxious by throwing lime at him, by
squirting petroleum and crude oil, and various
other ways, but that he was always in evidence
when the wind was in the direction in which it
was that day. There were many others further
out, and, personally, I could see no particular
29,9
THE DOCTOR'S PART
reason to be so disturbed about one individual.
At one end of the trench an automobile horn of
the Klaxon type, I think, was fastened, and
when that squawked it was better to put on your
mask, for it meant that the deadly gray, green
gas was coming. Aside from the occasional ex-
plosions of the German shells, it was very still,
the stillness of the high places accentuated by
the tension of ever waiting for the scream of
shells and the scrambling rush of an infantry at-
tack. It seemed like Sunday : the Sunday hush.
Of course there were no guns, cannon, up there ;
it was too close for that. They were back in
the valley and tossed their noisy, steel death
over the ranges and into the trench under the
guidance of telephone direction.
The Captain spread out his map and showed
us where the lines ran. We were then over at
one end of the trenches, and I left my little
French doctor friend and went back with the
Captain to his mess house, a little wooden shack
just behind the lines, where he promised me a
cup of tea. I was alone with the Captain, the
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FRONT LINES
others lagging behind. Just as the tea was
about to be served, before we had sat down,
there was a whining scream, which ended in a
jarring explosion, just outside. On the Cap-
tain's orders, we immediately "beat it" for his
dugout, which was not far away but far enough
to allow two more shells to explode before we
reached it. I did not know where the others
had gone : that was their business.
At the same time that we were in the front
trench an inspection had been made by a party
of French Engineer Officers, and it is probable
that the Germans, hearing an undue amount of
conversation and noise in the French trench,
had concluded that it would be well to shell it.
For an hour and a half we sat there and listened
to things blow up outside. The Captain's dug-
out was small, unpretentious and simple, but it
seemed very comfortable. It had a bunk and
table, one chair, and a small cooking stove. He
cheered me by telling me that if one of the larger
shells dropped on the dugout, we should all
disappear in fragments, as it was only about
231
THE DOCTOR'S PART
half completed and by no means shell-proof.
It did not sound good to me, but the whole
thing was so interesting that I did not have
much time to worry. They were firing 77 m.m.
and 150 m.m. shells all loaded with high explo-
sive, and the racket was tremendous. The explo-
sions were very sharp and shook and jarred
the ground, especially those which struck in our
immediate vicinity, and there were quite a num-
ber of these. Pieces rattled against the dugout,
and the air was filled with the whine of falling
shell fragments.
They also threw bombs ("minenwerfer"),
which added to the general racket, and when the
French machine guns opened up to check an
infantry attack which the Germans started, it
sounded like bedlam broken loose. In addition
to this, they also gave us the benefit of occa-
sional showers of hand grenades.
During the hour and a half that this demon-
stration lasted, they dropped forty-eight 150
m.m. and forty 77 m.m. shells on this small
comer of the French lines.
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FRONT LINES
To make it additionally interesting to me,
the Captain sat on one end of his bunk with his
telephone at his ear and I on the other end of
the bunk. From his end of the conversation I
could tell what was happening and what was
going to happen. I understood when "P-3"
(a designation of a part of his lines) called him
that P-3 reported a German infantry attack
starting opposite that position, and I heard
the order go to P-3 to open up with the machine
guns, and sure enough, in a few seconds we
heard the "put-put-put" — the "drumming of
the guns." Fortunately for my peace of mind,
that infantry attack died then and there ; they
got a very short distance beyond the German
trenches.
"P-2'* complained that the Boches were
knocking his trench to pieces by their artillery
fire. All right, we would fix that, so we tele-
phoned to a battery back in the valley and in a
few moments big French shells commenced to
scream over our heads on their way to Deutsch-
land. It must have helped, for P-2 called up
233
THE DOCTOR'S PART
soon after and said that the Germans had
stopped shelling him.
"La Coulee" we could not get at all. Tried
several times and finally gave up in disgust : it
was a case of "Ligne Coupee," which is not the
familiar "line's busy" of peaceful hours but
meant that a German shell had stepped on the
wire. It was like being in a prompter's box
behind the scenes, and the whole thing was too
fascinatingly interesting to allow much time
for being frightened. In the intervals between
telephone calls we chatted of common-place
things, and I made bad jokes in bad French to
show that the American Army was a good
sport. The Captain passed around some candy
and cake which had come up to him for his
Saint's Day, and I furnished some cigars, and
we munched and smoked and listened to the
telephone and the racket outside, and the good
little stove dried me out and I was really quite
contented. You see, if one came over here and
never heard shells burst or bullets whine, he
could not expect to excite much interest on his
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FRONT LINES
return to his own country. I felt that I was
really acquiring a noisy education which might
eventually lead to a wartime diploma.
At the end of an hour and a half the whole
thing stopped. It was carried out with Ger-
man method in three periods of a half hour
each, with an interval of some minutes between
each half hour's shelling, evidently with the
intention of drawing the French troops into
the trenches again where they would be sub-
jected to further shell fire in the open. The
wounded from this attack were not many ; the
exact number I do not recollect, but due to the
fact that the majority of the troops were with-
drawn to shelters and only the necessary num-
ber of lookouts left to give warning of the
infantry attack, the casualties were not nearly
so heavy as they would have been under other
circumstances.
There was, to me, a very sad ending to this
experience. I have spoken of the little French
doctor who was explaining to me his arrange-
ment in his shelter for the wounded and the
235
THE DOCTOR'S PART
manner in which he cared for his injured sol-
diers. I stated that I left him in the trench
just as I went down with the Captain for the
cup of tea, which I never got, in his mess house.
The second or third shell which dropped there
fell on this line of the trenches and one of them
squarely on the little doctor.
All that was left was shattered sand bags, a
hole in the parapet and some red splotches and
fragments of clothes on the parados. My little
medical friend disappeared then and there as
completely as though he had been translated
like Elijah in his chariot. A six-inch shell
loaded with high explosive (which means glori-
fied dynamite) leaves little trace of anything
in the immediate vicinity of its explosion.
In mountain country such as that described
above, the shelters for the wounded are con-
structed with a view to taking advantage, so
far as possible, of the natural protection af-
forded by the ground. Instead of being en-
tirely built up they are sunk into the side of the
hill, much as one would start the tunnel of a
236
FRONT LINES
mine. After a little distance, the cover of the
ground overhead gives adequate shelter from
shell bursts and up to that point this is pro-
vided by building up with tree trunks, earth and
rocks. The extent of this covering is about
fifteen or eighteen feet and this is sufficient to
take care of the smaller and medium caliber
shells ; for those of from 220 m.m. up, there is
hardly any man-made shelter which is sufficient
to afford immunity. These underground bur-
rows vary in dimensions from what is in effect
a straight rabbit burrow up to elaborate sys-
tems of underground habitations which include
several underground rooms, operating room,
ward, waiting rooms and quarters for the
detachment which mans them. I saw one such
in a first line Ambulance which was some thirty
feet under ground and was in reality an exceed-
ingly well arranged little hospital. It was
lighted by electricity, and could care for some
thirty patients at a time. Construction of
this type is the outgrowth of course of the fixed
front fighting, of the trench warfare where
237
D
Rej-u.g<
t
"a"
V
Front Line Shelter
238
n
Front Line Shelter
239
THE DOCTOR'S PART
there is no decided fluctuation in the advance
or retreat of the contending forces.
The continuance of this kind of warfare has
given ample opportunity to perfect the style
of these shelters and to-day they are built in
accordance with pretty definite rules. With
the smaller shelters, it is of course an object
to take advantage of all available space. In
view of this, the entrance and exit have a definite
arrangement as shown in the accompanying
diagrams. In "a" the entrance is not properly
placed, for in order to come in and out of the
dugout it is necessary for the wounded to
traverse the entire length of the shelter, thereby
interfering with work. In "b" the wounded
pass across one end of the dugout and do not
take up needed space. Many of the wounded
who come to the station do not need any-
thing more than an inspection to verify
the fact that their dressings are prop-
erly applied and that they are tagged,
and a man stationed at the entrance in
"b" can carry on this work without the neces-
240
FRONT LINES
sity for men passing through the entire length
of the shelter. Another advantage of this
arrangement is that there is a smaller target
afforded for hostile shell fire since the narrow
dimension of the dugout is presented to the
enemy. Finally, this arrangement gives the
two entrances which have been shown to be a
necessary precaution in the event that one be
closed by a shell explosion.
The construction of shelters of this type
means a great deal of labor, for the excavation
in itself is no mean j ob and oftentimes it means
work in rocky ground which magnifies the task.
In some of the shelters of this style which I saw,
"camouflage" had been cleverly employed. One
I remember particularly which was on a hill
side in plain view of the German lines. It was
in a forest and in the immediate vicinity most
of the trees had been felled for purposes of
construction. The clever French overcame this
difficulty by painting and setting up large can-
vas screens like a woods scene on the back drop
in a theater which effectually hid the Poste de
241
THE DOCTOR'S PART
Secour from prying enemy eyes — and shells.
The Medical Inspector with whom I visited this
station told me that it was commonly known as
*'The Theater" and seemed amused when I told
him that under those circumstances I should
be very glad to meet some of the chorus.
Much has been written of "camouflage" and
many jokes perpetrated at its expense, but I
can assure any of the jokers that it is a very
comforting sensation to know that you are
traversing in comparative safety a road or path
which without it would probably be an inferno
of shrapnel and high explosive. I have only
the most kindly and respectful attitude for that
overworked word and all that it really means in
the grim work of war.
Shelters of the type described and illustrated
are of course possible only where the terrain
lends itself to their construction : in hilly coun-
try. They are probably the most satisfactory
kind since by burrowing into the hillside it is
possible in a short distance to put enough earth
over your head to protect you against the
242
FRONT LINES
effect of the average shell burst. Since this is
not always possible, the character of the Poste
de Secour varies according to the country in
which it exists.
In flat country such as that of the Somme
or farther north, they often consist of a wide
ditch heavily roofed with sand bags ; not so
secure as the hillside type, but affording the
best protection under the circumstances. I
have seen them established in the cellars of un-
destroyed buildings and in cellars which still
existed under a pile of bricks and masonry, all
that was left of a shell torn house. Some of
them I have seen located in churches where the
surgeons carried on their work near the altar
and in the shadow of the cross. This did not
seem inappropriate somehow, for as Christ
strove to heal the wounds of the soul, so these
weary French Medical men were trying to
patch the bodily wounds in this His house; the
house of the Great Physician. Still others I
have seen which were nothing more than a
sheltering angle of standing wall and battered
243
THE DOCTOR'S PART
debris; scant protection save from the flying
steel fragments and the vicious whip of bullets.
Wherever they are located and however they
are made they are a tacit tribute to the recogni-
tion that in the warfare of to-day the essential
thing for the welfare of the soldier is prompt
treatment; as prompt as possible. Views have
changed in this respect since August, 1914.
Before that time it was generally conceded that
the majority of the serious surgical work should
be done at some distance from the fighting front,
in the Zone of the Interior. Experience proved
that this was wrong, and that a man's chances
for recovery decreased, to speak in terms of
mathematics, in direct relation to the time which
elapsed before he went on the table for opera-
tion. I do not intend to give the impression
that major operations are attempted in the
first line Sanitary Units. That of course is out
of the question, but even so, the treatment that
is accorded men at these places is much
better and more thorough now than formerly,
and the whole process is shoved up from the
S44
FRONT LINES
rear lines so that the wounded receive extended
care now at a point where formerly little was
done for them.
I think it cannot be difficult to understand
that this front line work is hard work for the
Medical personnel which carries it out. The
Doctors who do it are really entitled to a
different classification than that of "non-com-
batant." If "non-combatant" means just a
man who does not fight, they fall within the
category. But when you come to consider that
they bear in common with their brothers of the
line all the danger of these advanced positions ;
that they are subject to the same intense bom-
bardment, the same shock of assault, of gas and
all the nerve wracking terrors of life in the
trenches, it seems as though there ought to be
at least a brevet title which would differentiate
between the accepted meaning of the term and
the actuality in these circumstances. The wast-
age of Sanitary personnel has been high in the
present war and, aside from my little Doctor
who died a spattered mass on the wall of the
/
THE DOCTOR'S PART
parados, blown out of existence by German
high explosive, there may have been many
others who have found the end of the great
adventure while bringing aid and comfort to
their stricken comrades. The Croix de Guerre
and the Gold wound chevron on the right arm
is not uncommon on the uniform of the man who
carries the insignia of the Sanitary Service.
I would not have it understood that there is
any unusual courage among the men of the
Medical Profession who go to war, but to cor-
rect an impression more or less current that
their job lies well to the rear, safe from the
carnage of the combatant forces.
I think that there is one thought which oc-
curs to every man in contemplation of entrance
into battle: whether he is nervously waiting his
first experience under actual conditions, or
whether he is simply going through a period
of self analysis safe in his own home, with no
immediate prospect of exposure to the danger
of hostile fire.
That is, "What would I do the first time I
U6
FRONT LINES
was under fire? Would I run away? Would
I be afraid?" It is I think a perfectly natural
curiosity, and one that must occur to every
one in his soul analysis. The answer to part
of it at least, is in the record of armies since
the beginning of time, for armies as a whole
do not run away, and according to the law of
averages the normal man is not in that respect a
coward. It has always seemed to me that any
man in peril of his life, in danger of immediate
death, must have a certain amount of fear.
That this is in varying degree, and may be
lessened by constant exposure to the same sort
of danger; but that at the commencement of
any danger there must be for him the inevitable
dread of losing that which counts most to all of
us — life. Moreover, it has seemed to me that
this same fear is the governing factor in de-
termining whether one stands fast or deserts.
Man has in danger, two fears. One that he
will bcf killed. One that he will forever shame
himswtf in the eyes of his fellows by running
awji^. He stands as the pivotal point in the
Ml
THE DOCTOR'S PART
balance which carries on either pan these two
fears, and whichever one is the strongest, de-
termines him as brave man or coward. In other
words, I believe that the right kind of fear is
really bravery.
In a little book * written by a young French-
man named Paul Lintier who served until his
death with a battery of 75, there is such a clear
exposition of this that I have translated it and
am quoting it here. It seems to me to sum up
the situation very precisely, and we can excuse
to his pride in his arm of the service the special
reservation he makes for the Artillery soldier.
He was killed by a German shell while serving
with his battery and before he was twenty-three
years old.
"As far as we are concerned, there is
nothing to do. Over towards Stenay the sky
line is unchanged and empty. For some hours
past large shells have been dropping by threes,
marking with the punctuation of their black
* "Ma Piece" By Paul Lintier. Published by Plon-Nour-
rit & Co.. Paris. 1917.
MS
FRONT LINES
bursts, the fair green page of the prairie where
no troops are. We are easily in range of these
heavy guns and there is no certainty that at
any minute a change in their elevation may not
bring us under their fire. Yet no one seems
to think of it.
"I sometimes wonder at the marvelous qual-
ity of adaptability which is the base of human
character. We accustom ourselves to constant
danger just as we do to bitter privations, to
the uncertainty of the morrow.
"I used to ask myself, before the war, how
it was that the aged who had almost reached
the limits of human life, could live so peacefully
in the shadow of imminent death. Now, I think
I understand, for to us in these circumstances,
the risk of death has come to be just a part of
the daily routine. One counts on it and is little
astonished and less afraid. And then, each
day augments our courage.
"The human organism becomes callous under
repeated exposure to the same terrors and the
shaking nerves grow calm.
249
THE DOCTOR'S PART
"The steady fight for mastery of self wins
in the end and tluit is the courage of the soldier.
One is not born brave — he becomes so.
"The instinctive desire not to be overcome is
always a factor. Furthermore, one must live,
to the best of his ability, whether it be in the
turmoil of conflict, or in times of peace. You
have to accommodate yourself to this new
fashion of life, however wretched, however pre-
carious it be.
"Finally, the thing which counts above all
else — that which makes the situation almost
intolerable — is fear, the very essence of fear.
That must be overcome, and one does over-
come it.
"Together with the desire to live, no matter
how wretched life may be, the sense of duty and
regard for opinion — in a word, honor — is the
great educational factor in determining the
character of the soldier under fire. I do not
claim this as original ; it is merely my personal
evidence in the matter.
"Furthermore, I believe that this education
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FRONT LINES
in courage is easier for us than for the Infantry,
the hardest tried arm in the service. An artil-
leryman in action of a very truth carviwt run
away ; every one in his battery would see it ; his
disgrace would be patent to all and beyond
remedy.
*'So then, fear, extreme fear, seems to me to
be, in effect, the abolishing of the power of
will. The man who is not capable of stand-
ing calmly face to face with danger is also in
the majority of cases equally incapable of
overcoming that innate, dominant sense of
shame which would result from public flight.
For the act of running away there is requisite
a certain amount of will power, a sort of quasi-
bravery.
*'The Infantryman not infrequently finds
himself alone while in battle. Under cannon
fire a man crouched on the ground some four
meters from his nearest neighbor is in reality
very much alone. His individual fancies and
worries absorb all his attention and from this
cause he may yield to the temptation to lag,
251
THE DOCTOR'S PART
to hide himself and finally run away. Later in
the day when he has rejoined his company it
is easy to say that he lost his squad and joined
another. He has good grounds for supposing
that none of his comrades will know the truth —
and he has this knowledge before he deserts so
that he does not have to combat the overpower-
ing repugnance to a flight in full view of his
fellows.
"To stand fast under fire means much. To
preserve your sang froid is another proposition
in the hell of modern battle conditions. One
is instantly afraid; you sweat and your body
is shaken as though by an ague. It is irresist-
ible; it seems that there is no escape from
death. The form of danger is unfamiliar; one
you have never known. The imagination mag-
nifies it and you can neither think nor reason.
The burst of the shells, their acrid smoke and
the scream of the flying fragments add to the
stupor of these first moments.
"However, neither the flash of the exploding
melinite, the noise of the detonation nor the
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cloud of greasy black smoke is in itself a danger.
I think the significant fact is that they are the
accompanying heralds of the danger and that
they are all thrust on you at once and that it
is this which gives them their significance.
"Very soon one realizes that smoke in itself
is harmless : that the scream of the advancing
shell is the warning of its approach and of its
direction. You do not turn your back at every
shot and you take cover only with the certainty
that it is necessary.
**Then it is that we realize that fear has not
conquered us, but we it. There lies the crux
of the whole situation.
"Another thing which makes courage easier
for the Artilleryman is the very organization
itself of his service. The Infantry, the Cavalry,
the Engineers, each of them is a self-contained
unit. For us, the Artillery, the unit is the gun
itself. The seven men who serve it are the
intimately interwoven brain and sinew of a
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THE DOCTOR'S PART
being which with them comes to life — the gun
in action.
"This interlocking of seven men, each to the
other and all to the gun, renders any short-
coming so patent, so serious in its consequences
that the resulting shame could not be borne.
"Then also, this close affiliation makes easy
that mysterious psychologic transference of
thought and soul and the presence of one or
two brave and resolute spirits is often sufficient
to set the standard of courage for the entire
gun-crew."
There was a Poste de Secour of the cellar
type that I remember very vividly. It was in
the defenses about Verdun and I had made my
visit there thinking that I should be in time
to see something of a rumored French offensive.
As it turned out, I was a little too early and got
there during the preliminary artillery prepara-
tion. Artillery preparation has been described
a number of times by people who have better
command of adjectives than I so in regard to
what it is I merely mention that any pen pic-
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ture leaves one entirely at sea as to a realiza-
tion of the actuality. It is just magnified
noise which shakes your very being, physical
and mental ; a constant roar of the guns on your
side and the exploding shells from the counter-
battery work of the other.
This Poste de Secour was in what remained
of the cellar of a drunkenly battered chateau
and was in sight of those two hard fought for
points, the "Mort Homme" and "Hill 304."
About it was nothing but the evidence of the
destructive power of high explosive shells and
they were coming in with methodical regularity
while I was there. The cellar itself had been
shored up with heavy timber balks to give
additional resistance against any direct hit.
It was a vaulted chamber so low that I had to
stoop to make my way about, and the only
light was a few kerosene lamps and the little
French hand lights without a chimney which
are so common in the peasant houses. This was
presided over by a French Medical officer and
his detachment of "Infirmiers." An "Infirmier"
^55
THE DOCTOR'S PART
would correspond in our own service with a
Hospital Corps private who had received in-
struction in First Aid work and knew enough
to assist in dressing the wounds.
Among them was a man who had been in the
United States and I was amused, and a little
touched, by the immediate interest he took in
me and my uniform. He was eager to talk
and my queries in regard to conditions there
were often parried by him with requests for
information in regard to places in my own
country which he knew.
The Medical Officer said that he had been
in this sector for the past ten months and would
welcome life for a time in a quieter place, but
he seemed proud of his work and of what he
was doing for the wounded. Things were
necessarily crude; you cannot reasonably ex-
pect much "de luxe" when the main and essen-
tial object is to have a place which shall not
be battered about your ears by falling shell.
There was an operating table for such work
as was imperative ; the stopping of hemorrhage
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and anything that could not be deferred until
the wounded had reached the next point back.
There were supplies of dressings, arrangements
to give the men hot soup and some eight or
ten spring bunks fastened between the uprights
which shored up the cellar. There were some
wounded there waiting transport to the ambu-
lances of the rear; none very seriously hurt
though the occasional blood stains on a bandage
gave mute evidence that below the snowy cover-
ing there was an area of painful and tortured
flesh. They were a patient and uncomplaining
lot; just seemed to take it as a part of the
game and during the time I was there I heard
no moans, and no complainings: just the chat-
ter of low voiced French as they exchanged
views on the topics of their day.
The Medical Officer said that this was a hard
post since the wounded had to be transported
for some three quarters of a mile or more by
hand, and litter transport through a trench is
always a difficult problem. I asked him about
the various kinds of special litter which have
257
THE DOCTOR'S PART
been devised to meet the narrow angles of the
trenches and he shrugged his shoulders and
said that these were well enough in their way
and undoubtedly a good thing when you had
them — but in a large proportion of the cases
they were not available and they had simplified
the matter and come to a practical solution of
the matter. Each French soldier has a piece
of canvas which corresponds in a measure to
one of our shelter halves. These they use in
the transport through the trenches.
To illustrate, he had one brought out and
laid in the narrow aisle between the tiers of
posts and I lay down on it. It reached from
my head to about the middle of my lower leg.
They took up the diagonal corners (right leg
and left shoulder and left leg and right shoul-
der) and knotted them over the center of my
belly. Then a pole was slipped under the knots
and as they raised me from the floor the canvas
enveloped me as in a hammock. Unless there
is a fracture of the leg below the knee, the legs
swing down from the knee without support, thus
258
FRONT LINES
shortening the length of the litter and making it
possible to turn corners. It felt comfortable
and seemed practical, for the man almost always
has this sheet with- him and it is not difficult
to find a short pole or piece of plank to com-
plete the apparatus.
I was the recipient of a pretty piece of cour-
tesy in this sector. The men in the trenches
amuse themselves when they are not busy killing
the Boche or being killed by him, by making
such articles as their ingenuity and skill sug-
gest from fragments of shell and shell case. I
stopped in a trench to watch one of these first
line mechanics who was busy with file and pliers
and a little soldering outfit making "briquets"
which are the cigarette lighters which are so
common in France as a substitute for matches.
There were several completed on the fire step
before him and knowing that they were made
for sale I took out a roll of franc notes after
examining several of them. Before I could
make an offer this bearded dirty artisan turned
to me with a delightful smile and said: "Mon-
259
THE DOCTOR'S PART
sieur is not only the first American Officer who
has been in this trench, but also he is the first
American Officer I have had the pleasure of
seeing. That being the case, will monsieur le
Majeur (general term for a Medical Officer)
forget for a minute that I am merely a French
Poilu, allow me the courtesy that exists between
all gentlemen of whatever nation and accept
with my compliments such of these briquets as
may seem desirable to him? Please as a favor
to me."
Indeed I did. I blushed a little, put my notes
in my pocket and took the one I liked the best
and thanked Monsieur the Poilu for his fine
courtesy and good feeling. I still have that
briquet with my initials on it and the date and
the name of the sector. It was continual little
acts of sincere kindness such as this that en-
deared the French people to me. In two years
I never knew one who was not kindly and con-
siderate.
CHAPTER VII
CONCLUSION
Duty such as it was my lot to perform for
two years in France must, of necessity, have its
sad side as a marked feature. Constant asso-
ciation with the maimed and the sick does not
make for a cheery existence.
Yet, even so, there was much about it which
was very well worth while, aside from the pro-
fessional interest which can be understood.
From the standpoint of the wounded themselves,
there was the lesson of cheerfulness in adversity,
of patience under severe loss and the evidence
of trying to make the best of what circumstance
had left to build up and go on with. I have
referred in several of the preceding pages to
this trait among the wounded French and it
seems to me now, as I look back, to be par-
261
THE DOCTOR'S PART
ticularly fine and sometliing that it was well
to have seen and to know about.
This cheeriness had no evidence of being
forced; it seemed entirely spontaneous and to
be an innate part of the character. They met
things with their chins up and with a grin.
They had a joke or a comical word for almost
any situation providing it did not carry them
beyond the bounds of their strength. Then,"
though there might be no smile nor jest, the dig-
nity with which they closed their teeth and
silently endured the necessary merciful torture
was as fine to see as the lightheartedness of
their easier moments.
It is fortunate that even a Military Observer
of medical procedure can find at times a side
of life that is not quite so soberly tinctured
with pain and sadness as that which falls in
the field of his duties. Aside from those with
whom I came in contact in the course of my
official wanderings, I made many other friends.
I made many among those with whom I was
thrown officially and as I came to know them
262
CONCLUSION
better I was impressed with the fine courtesy
which was everywhere shown me.
We, here in the United States, have some
erroneous ideas in respect to the people of
France. The view that they are volatile, and
not a race of fixed determination and persever-
ance, is altogether at variance with their true
character, as will soon be apparent to any one
who is associated with them. Their true qual-
ity of determination and dogged persistence has
been too clearly demonstrated during the strug-
gle with Germany to allow one to continue in
this estimate. Again, I think that many of
us have been taught to believe that "French
courtesy" was a trait which existed only so far
as a surface manifestation went; that it was
superficial and not whole hearted. My own
experience went entirely to disprove this and
I found not only the courtesy of manner of
which I had heard but a simple and direct sin-
cerity and kindliness which added the solid body
to what without it would have been a shallow
veneer. I had ample opportunity to judge
263
THE DOCTOR'S PART
and was speedily convinced that my former
estimate had been altogether wrong.
Furthermore, they are not, physically, a
small people. They are not perhaps on the
average up to our standard of stature, but they
are extremely stocky and the men as a rule
well developed and thick through the chest.
The French *'poilu" trudges around winter and
summer loaded down with various articles of
equipment which make him look like an animated
Christmas tree, and he does it as an entire
matter of course and would be surprised, I
think, if any one suggested that his load was in
any way excessive.
A story was told me in this connection which
I think illustrates the point. On a long march,
one of the privates added to his own load the
pack of a comrade who was ill and not fit to
bear his own burden for the time being. One
of the Company Officers noticing the circum-
stance kept his eye from time to time on the
cheerful one who was doing double carrier duty.
As he passed him later in the march he was
264
CONCLUSION
astonished and a little perturbed to see that in
addition to his own and his comrade's pack the
soldier had super-imposed a good sized dog, the
company mascot. He called the soldier's at-
tention to the fact that he was already carrying
two loads and asked what he meant by adding
the dog to his already too large pack. The
Poilu looked at him gravely, and with the air
of explaining a perfectly simple state of affairs
responded, "Mais, mon Capitaine, le chien est
fatigue." I do not know whether that has any
foundation in fact, but I do know that they
carry with indifference as a daily routine a mis-
cellaneous assortment of equipment that it made
me tired just to look at.
One afternoon I was walking down the
Champs Elysee between two French officer
friends. One was six feet four and the other
six feet three. Stopping I commenced to
laugh : one of them said with the permissable
familiarity of friendship, "Well, idiot, what are
you laughing at now?" The other joined in,
"Yes, tell us the joke in order that we may
265
THE DOCTOR'S PART
laugh together if it is so funny." I explained,
that I was thinking from my lowly altitude of
five feet eleven inches of the description in my
early school Geography which stated that "The
French are a slight people, gay hearted and
fond of dancing and light wines." We laughed
together then, and if I am not mistaken in my
recollection, went across the Avenue to
Fouquet's, the famous, where we demonstrated
the fact that even if they could not live up to
the tradition in regard to the slight people, they
were both light hearted and appreciated the
vintage of the country.
One of the two gave me evidence of his sin-
cerity and feeling the day that news came that
I was no longer a Benevolent Neutral, but had
the right to be considered as one of them.
My office telephone rang and I recognized
the voice of my friend who asked in some agita-
tion if I should be in the office for a few minutes
longer. I assured him that I should and he said
that he wished to see me on a matter of im-
266
CONCLUSION
portance and would be there in a very short
while.
He came hastily into the office with a broad
grin on his face and immediately said, "Church,
I have told you a lie." I interjected, "Prob-
ably not the first, Charles," and he went on not
heeding the interruption. "I have no business
to talk, but I have just heard the news of the
United States and I did not wish any one else
to be the first to greet you as an Ally: please
tell me that I am the first." I assured him
that he was and with a whoop he gathered me
to a very broad, blue clad French breast and
I emerged with aching ribs and somewhat
heightened color, to realize that I had been
kissed on both cheeks by a very enthusiastic
and also a very capable and distinguished Officer
of the French Army. A New England con-
science forces me to admit that, on this occasion
also, we motored to M. Fouquet's and cemented
the new union in a perfectly proper and excel-
lently well made concession to the Western Hem-
isphere, a Martini cocktail, "bien sec." The
267
THE DOCTOR'S PART
French love to tease, "taquiner" as they put it.
They are as good at it as any of us Yankees
and quite as clever. They tease each other
without end, and if they decide that they like
you, they tease you too: and you do not mind
it, for it is very good natured and you tease
them back again and if you get the best of one
of them his comrades will take it up with him
and guy him unmercifully.
Their relations with each other in the Army
are simple and in a way less formal than in
our own service. I do not mean to intimate
that there is any lack of discipline nor loss of
the formal courtesies, but they can seemingly
let down the bars in situations where to us there
would be no passing. On one trip I made, I
had as my mecanicien a very nice chap who was
the grandson of Violet-le-Duc, the famous archi-
tect under the third Napoleon. I had a letter
to a Medical Officer with a certain army and,
when in answer to my message sent in to his
office he came out to greet me, the first thing he
did after a hurried word to me was to go to
268
CONCLUSION
the other side of the automobile, pull my
mecanicien out by his collar, throw his arms
around him and laugh and chatter for some
minutes. He was a Major in the Medical Corps
and the jnecanicien a private in the Automobile
Service. He explained that he and the mecanir
cien had been desk mates in school in Paris
twenty years before and that this was the first
time they had met; and he asked me with a
little doubtful touch of embarrassment, if it
would offend me to come to dinner that evening
with him, the mecanicieny and his friend the
chauffeur.
I told him I thought I could make that con-
cession in view of the fact that the chauffeur,
the Tnecanicien, my companion and I had been
eating all our meals together since we had
started about a week previously. We had a
jolly dinner that night and the next night the
mecanicien entertained in our honor. It was
all simple and natural, and when we set out on
tour with the machine the mecanicien was the
careful, respectful private, watchful to do
269
THE DOCTOR'S PART
everything possible for the comfort of the offi-
cers whom he served and not at all disturbed
or puffed up by any familiarity which might
have engendered from the fact that we had all
been dining and drinking good French wine to-
gether the night before. They seem to slide
easily from the relation of strict Military
regime to the more personal one and back again
with never a touch of undue or offensive famil-
iarity. I do not think we could do it in our
own service, but as the old song puts it, it is,
I expect, "because we ain't built that way."
For some months, while I was serving on our
own Headquarters Staff, I was billeted with
two very delightful old French people. Mon-
sieur and Madame R . When I moved into
my quarters 1 think they were a little dubious
as to what the barbarian American might be
like and I remember the look of relief which
flitted over Madame's kindly face when I took
off my cap and, apologizing in my best French
for the intrusion, assured her that I would be as
little trouble as possible. Figuratively, she
270
CONCLUSION
took me to her heart then and there and from
that time on I was to all intents and purposes
a member of the household, and so they dubbed
me, "le fils du maison." Her husband was
seventy-two, spent much of his time riding a
bicycle and all the rainy, cold days out with a
gun and dog, hunting, Madame was some sixty
odd and quite as active as her husband. He
was an inveterate tease and between us we used
to plague Madame to her pretended distraction,
but I know she liked it. They did everything
possible to add to my comfort in their spot-
less house and when my orders took me from the
village and from France, she put her arms
around my neck and frankly crying, said as she
kissed me good bye, "But my son, my son, we
shall miss you so." It is not hard to like, to
be fond of, people who treat you so.
My office there was about a mile from the
house where I lived with M. and Madame R •
and in the winter it was quite dark when the
time came for me to go home: the early dark-
ness of winter at half past five. Almost every
271
THE DOCTOR'S PART
evening I walked home with a young lady; for
a long time I did not know whether she were
pretty or not, nor her name. She never asked
me to call in spite of the fact that she lived just
across the street from me and that we always
held hands as we came along the dark streets.
I found out later that she was pretty, and that
her name was Marcelle. You see Marcelle was
just nine years old, and she got out of school
just about the time I came home. And so,
when I got to a certain corner there was a
patter of little feet, the swish of thin little
skirts, a little cold hand slipped into mine and
a childish treble which piped, "C'est Marcelle,
mon Colonel," and away we went, the big Ameri-
can officer and the little French refugee from
invaded France, for such she was.
She told me that the arithmetic had been
hard that day, or the teacher cross, and of what
she hoped to have for supper and the news of
mother and her little brother. She was always
cheerful and always very punctilious, with her
"Oui, mon Colonel," and "Mais certainement,
272
CONCLUSION
mon Colonel," and when we parted at the door
she never failed to wish me a good appetite and
sound slumber. Poor little waif; she had
lived in Picardy somewhere until driven out by
the German invasion when they had drifted to
this town where her mother by dint of daily toil
and such aid as the village people could give
her, kept the little family in food and the
meager black they wore. The husband and
father had been called, as all France was, to the
colors and after one of the engagements news
came that he was missing. Just that one
agonizing word : and from that time on he had
been only a memory, a wistfully hoped for per-
son who would never return to find those whom
war and invasion had driven from the humble
home in Picardy so far afield. Not all the
tragedies are in the men who are killed or
wounded. If war is hard for those who bear
the brunt of the attack and whose bodies carry
the mark of hostile steel, there is still a world
of silent agony, of waiting suffering for those
who can only bear with weary patience the days
273
THE DOCTOR'S PART
and months which elapse after son or father or
husband has gone to the wars.
To the killed and the wounded there is added
that category which has always seemed to me to
be, by the very uncertainty of it, the hardest
to bear. I mean the hopeful, hopeless, state
which is entered under the head of "missing."
"Missing" may mean so much, and at the same
time, so little. In the majority of cases it
signifies that he whose name is so carried is
killed. Either lying undiscovered in some part
of that withered stretch called "No Man's
Land," or that he has been literally blown to
nothing by the rending power of high explo-
sive, or perchance that the shell which killed
him has covered his torn body with a mantle
of earth which hides it from all searching eyes.
There are others missing too; those who have
not fallen in battle. The fate of many who had
the evil fortune to fall into German hands in the
captured country will be for all time a mystery
to those who wait with wistful eyes and aching
hearts for news which will never come. It was
274
CONCLUSION
this variation of conditions, this constant
change of scene and association which gave a
pecuHar interest to the work as Military
Observer.
To the zest of the pursuit of desired informa-
tion was added the contact with many people
of interesting personality, and the constant
change of environment. While still the repre-
sentative of a neutral power I spent a month
on the island of Corsica. During the days
prior to the rupture of our peaceful relations
with the German Government, our Embassies,
both at Paris and Berlin, were charged with
the supervision of the conditions existent in the
various prison camps of both nations. Com-
plaints were referred to our Ambassadors by
the warring powers and investigated through
this agency. I was sent with others delegated
from our Embassy at Paris to look into condi-
tions in the Corsican camps and, as a conse-
quence, spent a month in the Corsican moun-
tains. It was interesting aside from the duties
to be performed for the country is probably
275
THE DOCTOR'S PART
the most picturesque in the world and the op-
portunity to explore it by automobile an un-
usual privilege.
So far as the camps and the conditions in
them were concerned, there was little to take
exception to. The lot of a prisoner of war
is naturally not an enviable one and the re-
striction and the routine of course irksome.
So far as we could determine, those who
were confined were as well treated as the re-
sources of the state permitted. There were
no luxuries but when the men of France were
undergoing what is incident to life in the
trenches it would be folly to expect better for
those who had fallen before the prowess of their
arms. The Germans were better housed than
the French in the field and as well fed. The
general objection seemed to be, not that they
were badly cared for, but an unreasoning ob-
jection to being prisoners at all. I could well
understand this, for to me being a prisoner of
war with the attendant inaction and dull rou-
tine seems one of the lowest forms of amuse-
276
CONCLUSION
ment. In one of the camps I asked if there
were present any one who spoke English. One
of the men stepped forward, and since the
French Captain who commanded the prison also
spoke and understood English, I was allowed
to talk to the man in that language. I asked
him various questions in regard to conditions
which he answered fairly with a degree of philos-
ophy, and concluded by saying, "I have no
complaint to make of my treatment, Major;
the French, I do not doubt, do the best they
can for us, but I must confess that I am not as
well cared for as I was before I was interned/'
In answer to my inquiry, he replied, "Oh, be-
fore the war I was one of the head waiters at the
Ritz in Paris, and there is a quite marked con-
trast between conditions there and here in
Corsica."
What sympathy I had, not much frankly,
was with these civil internes rather than
with the fighting men who had been given
their chance, had taken their turn in the
trenches and by the fortunes of war were now
m
THE DOCTOR'S PART
spared the hazard of further danger. The
civilian had not even that service to look back
on. Merely the knowledge that he was so much
available man power that had been lost to his
Government through the inadvertence of his
having been in the wrong place at the wrong
time. At the hotel in Bastia we were waited
on by a cheerful Boche who answered to the
name of "Willie." Willie had been, prior to
hostilities, a waiter in the Continental hotel in
Paris and according to his own statement, hav-
ing little taste for martial career, had decided
to emigrate to the United States when war
seemed imminent in 1914. He delayed one
steamer too long and the drag net swept him
up and landed him in this Isle of the Vendetta,
there to regret his procrastination. He was a
good waiter and aside from the fact of his
nationality perfectly acceptable. He spoke
French of sorts and English of sorts also, but
I think that there was always in his square head
an undercurrent of German stupidity. I
bought one of the cheeses which they make in
278
CONCLUSION
Corsica and which are much like the Roquefort
of France. As it developed a frank cheese
aroma, I asked Willie to wrap it and mail it
to my address in Paris, rather than have it
continually advertising its existence in my be-
longings. The next day I asked Willie if he
had executed my commission and with the pride
of duty well accomplished he replied, "Oh, yes,
sir, I wrapped him and sent him to-day; and
that he might go safely I wrapped him in a
bottle." Now that cheese was some nine inches
square and how even Willie could have
"wrapped him in a bottle" was beyond my com-
prehension. One of my companions asked me
if *Vrap" meant anything in French. It did,
and it does, and Willie wandering in the mazes
of his three tongues had put a French con-
struction on that good English word and turned
it into "raper" which means "to grate." On
my arrival in Paris I found a very large bottle
into which had been grated with methodical
German thoroughness all of that very good
cheese.
279
THE DOCTOR'S PART
Paris in war is not the Paris of peace. The
beauty of the city is the same but the light-
heartedness is gone. It is no longer the play-
ground for all the world but the heart and soul
of a very real and very near and very grim
struggle. It is a sad city but not a despondent
city. There is everywhere in it the evidence of
the sacrifices a nation is making to preserve its
integrity. Men in civil clothes are only those
who are unfit for Military service: there are
many women in black but they have not lost
their courage nor the proud consciousness
that the loss which is theirs means a supreme
gift to the State. There is no music save the
occasional rhythm of an army band which es-
corts some regiment on its way to the front,
or follows a black catafalque to the last resting
place in Pere la Chaise.
Dance they do not in war time and all cafes
close decorously and finally at half after nine.
It is a Paris shorn of the frivolities, peopled by
wounded men who are still gay on their
crutches, and with the ever-deferred-to "per-
280
CONCLUSION
missionaire" who has come back to "Paname"
for the joy of his ten days' respite from the
trenches. It is an interesting world, and I
think more cosmopolitan now than it was in the
days of happy peace. One meets here now, as
he used to at Shepherd's in Cairo, all the world
from everywhere and this is natural since our
entry as an Ally, for to this city, the heart of
France, come all those who can wheedle the
State Department into issuing that rara avis,
a passport to France.
I read the other day, the answer of an
Aviator who was asked the most thrilling mo-
ment he remembered in connection with the war.
It was, "Pershing's arrival in Paris."
I should have said the same thing. You see,
for many months we of the American Military
Mission had been here, in the heart of things;
becoming each day more and more imbued with
the spirit which was later to actuate the whole
Nation. Forced by the necessities of Diplo-
matic custom to preserve a smiling and imper-
sonal front with never a chance to express the
281
THE DOCTOR'S PART
convictions which had grown up within us;
drab as our sedate civilian attire and politely
tolerated by the French as some curious kind of
third sex.
And then came the April 6, 1917, and the
right to put on the service uniform and know
that it stood for a power of help and not as the
badge of an indifferent foreigner. And after
that, Wednesday, May the thirteenth, when
Pershing arrived as the visible evidence that we
were to take our part in the struggle.
It was a very wonderful coming. There was
no notice of it in the morning papers : no refer-
ence in those at noon, and only a short note in
the evening press which was on the streets at
four o'clock. How all Paris learned of the
fact I do not know, but learn they did and the
ovation they gave to this General from over
the sea was wonderful to see and doubly im-
pressive from the fact that it was impromptu.
At five-thirty, the Gare de I'Est was crowded
and surrounded by a dense pack of people. In-
side, preparations had been made for a fitting
282
CONCLUSION
reception. JofFre was there, and Poincare and
many high officials, and drawn up on the station
platform was a battalion of Infantry in full
marching order and flanked by the band of the
Garde Republicaine. The arrival of the General
in the station, his greetings by the high French
officials, the blare of the band, the French vet-
erans who stood fixed at "present arms" — all
this was impressive, but to my mind it was insig-
nificant in comparison to the homage of the
waiting thousands without.
All the way down the rue Lafayette, ap-
propriate entry for the United States on such
an occasion, and on over the two miles which
lay between the station and the hotel, these
Paris streets were dense with those who wished
to see the vanguard of the new Allies. There
was no hysterics, no superabundance of enthu-
siasm, but a sober confidence, an apparent be-
lief that the force needed to weigh down the
scale had come at last. There was to me some-
thing inexpressibly touching in it; something
that thrilled one and made the whole being tin-
283
THE DOCTOR'S PART
gle with pride and emotion. As General Persh-
ing went out on the balcony of the Hotel Cril-
lon facing the Place de la Concorde and bared
his head to the cheering crowd below, one was
conscious of the emotion which stirred him,
which must have been inevitable in the face of
such a demonstration of faith and confidence
and I think we all had an inkling of the thoughts
which must have been his.
It was a spectacle I shall always remember
and be glad to remember: I am proud to think
that I was permitted to see it and that there
was accorded me, before and after this, some
chance to aid in the common cause, to fulfill that
which is the wish of every normal man, to give
of his own effort the best he can when his coun-
try calls.
THE END
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